title: Chinese SLE Treatment and Research Group (CSTAR) registry:VIII. Influence of socioeconomic and geographical variables on disease phenotype and activity in Chinese patients with SLE.
abstract: OBJECTIVE
  The aim of this study was to estimate the influence of socioeconomic and geographical variables on disease phenotype and activity of systemic lupus erythematosus (SLE) in a Chinese population.
  
  
  METHODS
  Data on 904 therapy-naïve SLE patients from the Chinese SLE Treatment and Research Group (CSTAR), which is a nation-wide database of SLE patients, were used to evaluate the influence of socioeconomic status (SES) and geographical regions on disease phenotypes. The influence of regional climate and economic variables (i.e., data from the database of the Chinese Statistical Yearly Annals) on disease activity and nephropathy was further analyzed in a multivariate analysis to identify some of the environmental factors contributing to SLE.
  
  
  RESULTS
  Phenotype differences in SLE were found between patients with different SES. In the multivariate regression analysis that considered regional economic and climate factors, after adjusting for age, gender and disease duration, lower educational levels (β: -0.122, P = 0.001), lower availability of medical technical personnel (MTP) per 1000 people (β: -0.192, P < 0.001), higher annual duration of sunshine (β: 0.178, P = 0.010) and residence in southern China (β: 0.165, P = 0.001) were significantly associated with higher disease activity scores. Living in southern China (odds ratio [OR]: 1.907, P = 0.002) seemed to be a significant risk factor for nephropathy. A high number of MTP per 1000 people (OR: 0.951, P = 0.014) and relatively high temperatures were determined to be protective factors for nephropathy (OR: 0.946, P = 0.011).
  
  
  CONCLUSIONS
  The phenotype pattern and disease activity varied between SLE patients by SES and other regional variables, such as educational level, availability of medical technical personnel, annual sunshine duration and regional temperature.
authors.affiliation: Department of Rheumatology, National Center of Gerontology, Beijing Hospital, Beijing, China.
authors.forename: Yongjing
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: Mengtao
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: Jiuliang
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Rheumatology, The Fourth People's Hospital of Shenzhen Affiliated to Guangdong, Medical College, Guangdong, China.
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Department of Rheumatology, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Caifeng
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Rheumatology, The Second Hospital of Shanxi Medical University, Shanxi, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Clinical Immunology and Rheumatology, Xijing Hospital affiliated to the Fourth Military Medical University, Shanxi, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhu
authors.affiliation: Department of Rheumatology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Rheumatology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Rheumatology, Anhui Provincial Hospital, Anhui, China.
authors.forename: Xiangpei
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Rheumatology, Jiangsu Provincial People's Hospital, Jiangsu, China.
authors.forename: Miaojia
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology, National Center of Gerontology, Beijing Hospital, Beijing, China.
authors.forename: Cibo
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Rheumatology, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zeng
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D002980:Climate; D016208:Databases, Factual; D004522:Educational Status; D005260:Female; D006282:Health Personnel; D054625:Healthcare Disparities; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008181:Lupus Nephritis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010641:Phenotype; D065840:Protective Factors; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D012923:Social Class; D012959:Socioeconomic Factors; D013472:Sunlight; D013696:Temperature; D055815:Young Adult
keywords: 
  SLEDAI
  ; geographical variable; lupus nephritis; socioeconomic status; systemic lupus erythematous