Table 4.
Comparison of male and female African American SLE (n = 785).
| Characteristics/manifestations | Male, n = 53 | Female, n = 732 | OR | Adjusted |
|---|---|---|---|---|
| n (%) | n (%) | (95% CI)* | p* | |
| Cumulative clinical and laboratory features | ||||
| Age at last assessment, yrs | ||||
| ≤ 30 | 7 (14.0) | 138 (19.1) | 1.3 (0.6, 3.1)** | 0.5202† |
| > 30 | 43 (86.0) | 586 (80.9) | ||
| Age at onset, yrs | ||||
| ≤ 30 | 18 (34.6) | 436 (60.0) | 1.7 (0.5, 5.6)** | 0.4145 |
| > 30 | 34 (65.4) | 291 (40.0) | ||
| Age at diagnosis, yrs | ||||
| ≤ 30 | 17 (32.1) | 387 (53.0) | 2.2 (1.0, 4.9)** | 0.0481†† |
| > 30 | 36 (67.9) | 343 (47.0) | ||
| Education level, yrs | ||||
| ≤ 12 | 28 (62.2) | 313 (44.9) | 1.8 (1.0, 3.5)** | 0.0705 |
| > 12 | 17 (37.8) | 384 (55.1) | ||
| Obesity | 23 (46.0) | 420 (58.0) | 0.6 (0.3, 1.1) | 0.0749 |
| Disability | 22 (43.1) | 197 (27.6) | 1.9 (1.0, 3.5) | 0.0395 |
| History of smoking | 31 (58.5) | 279 (38.2) | 2.0 (1.1, 3.6) | 0.0327 |
| Clinical features | ||||
| Malar rash | 16 (30.2) | 325 (44.4) | 0.7 (0.4, 1.2) | 0.2041 |
| Discoid rash | 23 (45.1) | 219 (30.0) | 1.6 (0.9, 3.1) | 0.1186 |
| Photosensitivity | 20 (37.7) | 306 (41.9) | 1.0 (0.5, 1.8) | 0.9696 |
| Oral ulcer | 17 (32.1) | 304 (41.5) | 0.7 (0.4, 1.3) | 0.2687 |
| Alopecia | 24 (45.3) | 521 (71.3) | 0.3 (0.2, 0.5) | < 0.0001 |
| RP | 20 (37.7) | 361 (49.4) | 0.7 (0.4, 1.3) | 0.2722 |
| Arthralgias | 46 (86.8) | 690 (94.3) | 0.4 (0.2, 1.1) | 0.0698 |
| Arthritis | 38 (73.1) | 572 (78.6) | 0.8 (0.4, 1.6) | 0.5264 |
| Proteinuria | 34 (65.4) | 403 (55.4) | 1.9 (1.0, 3.6) | 0.0450 |
| Nephrotic syndrome | 13 (26.0) | 194 (26.9) | 1.0 (0.5, 2.1) | 0.9531 |
| Hematuria | 21 (40.4) | 265 (36.5) | 1.4 (0.8, 2.6) | 0.2431 |
| Renal insufficiency | 24 (46.2) | 187 (25.7) | 2.7 (1.5, 5.0) | 0.0012 |
| Renal failure | 11 (20.8) | 86 (11.8) | 2.1 (1.0, 4.7) | 0.0599 |
| Renal biopsy | 23 (43.4) | 268 (36.6) | 1.5 (0.8, 2.7) | 0.2176 |
| Lymphopenia | 28 (53.9) | 287 (39.4) | 1.6 (0.9, 2.8) | 0.1295 |
| Thrombocytopenia | 16 (30.8) | 161 (22.0) | 1.5 (0.8, 3.0) | 0.1982 |
| Laboratory findings | ||||
| Coombs positivity | 13 (29.6) | 158 (26.0) | 1.1 (0.5, 2.2) | 0.8299 |
| Lupus anticoagulant | 13 (27.7) | 166 (23.5) | 1.2 (0.6, 2.4) | 0.5978 |
| Anti-Sm | 17 (33.3) | 197 (27.6) | 1.4 (0.7, 2.6) | 0.3096 |
| Anti-dsDNA | 34 (64.2) | 485 (66.3) | 1.1 (0.6, 2.0) | 0.8506 |
| Low C3 | 31 (59.6) | 432 (59.0) | 1.2 (0.6, 2.1) | 0.5971 |
| Low C4 | 22 (42.3) | 358 (49.0) | 0.8 (0.5, 1.5) | 0.5215 |
| History of hypertension | 39 (73.6) | 472 (64.5) | 1.3 (0.7, 2.7) | 0.4119 |
| Deep vein thrombosis | 8 (15.4) | 97 (13.3) | 1.4 (0.6, 3.1) | 0.4043 |
| SLICC/ACR Damage Index | ||||
| Neuropsychiatric damage | ||||
| Cognitive impairment | 8 (15.7) | 42 (5.8) | 2.7 (1.1, 6.7) | 0.0282 |
| Seizures requiring therapy for 6 mo | 4 (7.8) | 31 (4.3) | 2.4 (0.8, 7.3) | 0.1212 |
| Renal damage | ||||
| GFR < 50% | 12 (23.5) | 62 (8.6) | 3.1 (1.4, 6.6) | 0.0039 |
| Proteinuria 3.5 g/24 h | 8 (15.7) | 88 (12.2) | 1.4 (0.6, 3.5) | 0.4906 |
| Endstage renal disease | 6 (11.8) | 57 (7.9) | 1.8 (0.7, 4.9) | 0.2441 |
| Pulmonary damage | ||||
| Pulmonary fibrosis | 7 (13.7) | 68 (9.4) | 1.5 (0.6, 3.6) | 0.4199 |
| Cardiovascular damage | ||||
| Angina | 2 (3.9) | 20 (2.8) | 1.1 (0.2, 5.3) | 0.8679 |
| Myocardial infarction | 6 (11.8) | 32 (4.4) | 1.7 (0.5, 5.2) | 0.3745 |
| Cardiomyopathy | 7 (13.7) | 42 (5.8) | 1.7 (0.6, 4.6) | 0.3011 |
| Left ventricular hypertrophy | 9 (18.0) | 74 (10.5) | 2.0 (0.9, 4.5) | 0.0908 |
| Venous thrombosis | 3 (5.9) | 23 (3.2) | 2.3 (0.7. 8.2) | 0.1913 |
| Hypertension for > 6 mo | 34 (69.4) | 315 (43.8) | 2.4 (1.3, 4.7) | 0.0085 |
| Musculoskeletal | ||||
| Avascular necrosis | 6 (11.5) | 112 (15.4) | 1.0 (0.4, 2.4) | 0.9397 |
| Malignancy | 6 (12.0) | 63 (8.7) | 1.4 (0.6, 3.5) | 0.4783 |
| Death | 12 (22.6) | 65 (8.9) | 2.8 (1.4, 5.8) | 0.0042 |
*
Adjusted for ethnicity, history of smoking, age at last assessment, and duration of SLE at last assessment.
**
The ratio of the odds of the event “> 30,” or ≤ 12,” occurring in males to the odds in females.
†
Adjusted for ethnicity, history of smoking, and duration of SLE at last assessment.
††
Adjusted for ethnicity, history of smoking, and age at last assessment. GFR: glomerular filtration rate; SLE: systemic lupus erythematosus; RP: Raynaud’s phenomenon; SLICC/ACR: Systemic Lupus International Collaborating Clinics/American College of Rheumatology.