title: Prevalence of systemic lupus erythematosus and associated comorbidities in Puerto Rico.
abstract: OBJECTIVE
  To examine the prevalence of systemic lupus erythematosus (SLE) and its associated comorbidities in patients from Puerto Rico using a database from a health insurance company.
  
  
  METHODS
  The insurance claims submitted by physicians in 2003 to a health insurance company of Puerto Rico were examined. Of 552,733 insured people, 877 had a diagnosis of SLE (code 710.0) per the International Classification of Diseases, Ninth Revision (ICD-9). Demographic parameters and selected comorbidities were determined. The diagnosis of comorbities was ascertained using the ICD-9 code, the Current Procedural Terminology-4 code (for disease-specific procedures) and/or the Medi-Span Therapeutic Classification System (for disease-specific pharmacologic treatment). Fisher exact test and chi were used to evaluate differences between SLE patients groups.
  
  
  RESULTS
  The mean age was 42.0 +/- 13.5, and the female-to-male ratio was 12.5:1. The overall prevalence of SLE was 159 per 100,000 individuals. The prevalence for females was 277 per 100,000 women and for males it was 25 per 100,000 men. The most common comorbidities were high blood pressure (33.7%), osteopenia/osteoporosis (22.2%), hypothyroidism (19.0%), diabetes mellitus (11.6%), and hypercholesterolemia (11.6%). Overall, high blood pressure, diabetes mellitus, hypercholesterolemia, and coronary artery disease were more prevalent in SLE patients older than 54 years. Osteopenia/osteoporosis was more prevalent in women than in men.
  
  
  CONCLUSIONS
  The prevalence of SLE in Puerto Rico is very high. High blood pressure, diabetes mellitus and hypercholesterolemia, hypothyroidism, and osteopenia/osteoporosis are common comorbidities in these patients. Identification and management of these comorbidities are critical for optimal medical care to this population.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
authors.forename: María J
authors.initials: MJ
authors.lastname: Molina
authors.forename: Angel M
authors.initials: AM
authors.lastname: Mayor
authors.forename: Alejandro E
authors.initials: AE
authors.lastname: Franco
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Morell
authors.forename: Miguel A
authors.initials: MA
authors.lastname: López
authors.forename: Luis M
authors.initials: LM
authors.lastname: Vilá
mesh_terms: D000293:Adolescent; D000328:Adult; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D019992:Databases as Topic; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005568:Forms and Records Control / Q000706:statistics & numerical data; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007037:Hypothyroidism / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology