title: Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) is affected by numerous clinical variables, including disease activity, damage, fibromyalgia, depression and anxiety. However, these associations have not yet been described in Mexican patients with systemic lupus erythematosus (SLE).
  
  
  OBJECTIVE
  To evaluate the relationship between disease activity, damage, depression and fibromyalgia and HRQOL measured by the LupusQoL-instrument in Mexican patients with SLE.
  
  
  METHODS
  A cross-sectional study was conducted in women fulfilling the 1997 ACR classification criteria for SLE. HRQOL was evaluated using a disease-specific instrument for SLE, the LupusQoL (validated for the Spanish-speaking population). Patients were evaluated clinically to determine the degree of disease activity and damage using the Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) and Systemic Lupus International Collaborating Clinics-Damage Index (SLICC), respectively. Fibromyalgia and depression were assessed using the ACR criteria and the CES-D scale, respectively. The relationship between HRQOL and these variables was measured using Spearman's rank correlation coefficient and linear regression analysis.
  
  
  RESULTS
  A total of 138 women with SLE, age 40.3±11 years, disease duration 8.8±6.4 years, with disease activity in 51.4%, depression in 50%, damage in 43% and fibromyalgia in 19.6% were included. Poorer HRQOL correlated with depression (r = -0.61; p< 0.005), fibromyalgia (r = -0.42; p< 0.005), disease activity (r = -0.37; p < 0.005) and damage (r = -0.31; p < 0.005). In the multivariate linear regression analysis, damage (β = -3.756, p<0.005), fibromyalgia (β = -0.920, p<0.005), depression (β = -0.911, p<0.005) and disease activity (β = -0.911, p<0.005) were associated with poor HRQOL.
  
  
  CONCLUSIONS
  SLE disease activity, damage, fibromyalgia and depression were associated with poor HRQOL in our sample of Mexican SLE patients.
authors.affiliation: Physiotherapy Program, Medical School, Benemérita Universidad Autónoma de Puebla, Puebla, México.|Systemic Autoimmune Diseases Research Unit, Regional General Hospital #36, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: I
authors.initials: I
authors.lastname: Etchegaray-Morales
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Regional General Hospital #36, Instituto Mexicano del Seguro Social, Puebla, México.|Puebla Research Coordination, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: S
authors.initials: S
authors.lastname: Méndez-Martínez
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Regional General Hospital #36, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: C
authors.initials: C
authors.lastname: Jiménez-Hernández
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Regional General Hospital #36, Instituto Mexicano del Seguro Social, Puebla, México.|Department of Rheumatology, Benemérita Universidad Autónoma de Puebla, Puebla, México.
authors.forename: C
authors.initials: C
authors.lastname: Mendoza-Pinto
authors.affiliation: Department of Psychology, Medical School, Benemérita Universidad Autónoma de Puebla, Puebla, México.
authors.forename: N E
authors.initials: NE
authors.lastname: Alonso-García
authors.affiliation: Division of Health Research Highly Specialized Medical Unit, Traumatology and Orthopaedics Hospital, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: Montiel-Jarquín
authors.affiliation: Highly Specialized Medical Unit, Speciality Hospital of Puebla, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: López-Colombo
authors.affiliation: Medical School, Universidad de las Américas Puebla, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: García-Villaseñor
authors.affiliation: Clinical Research Centre of Morelia, Michoacán, México.
authors.forename: M H
authors.initials: MH
authors.lastname: Cardiel
authors.affiliation: Systemic Autoimmune Diseases Research Unit, Regional General Hospital #36, Instituto Mexicano del Seguro Social, Puebla, México.|Department of Rheumatology, Benemérita Universidad Autónoma de Puebla, Puebla, México.|Department of Immunology, Benemérita Universidad Autónoma de Puebla, Puebla, México.
authors.forename: M
authors.initials: M
authors.lastname: García-Carrasco
mesh_terms: D000328:Adult; D003863:Depression / Q000150:complications; D005260:Female; D005356:Fibromyalgia / Q000150:complications; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology*; D008800:Mexico; D008875:Middle Aged; D011788:Quality of Life