Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of systemic lupus erythematosus and risk factors in rural areas of Anhui Province

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Systemic lupus erythematosus (SLE) is a severe complex rheumatic disease, but good estimate of its prevalence and risk factors is lacking in China. The aim of the study was to explore the prevalence of SLE and risk factors in rural areas of Anhui Province of China. Eleven counties were randomly selected in Anhui Province, and then, 15 % of the villages in selected counties were randomly sampled as study sites. Patients with SLE were identified through two phases. Based on the cases identified, a population-based case–control study was designed to examine risk factors associated with SLE. A total of 1,253,832 individuals and identified 471 SLE cases were surveyed. Crude and age-standardized prevalence were estimated at 37.56 and 36.03 per 100,000 persons, respectively. Gender difference in the prevalence of SLE was significant (P = 4.62 × 10−76), and the age-standardized prevalence was 6.17 for males and 67.78 for females per 100,000 persons. The distribution of SLE prevalence was significant by age group (P = 1.78 × 10−53), and the peak prevalence was observed at 40–50 years. Multiple environmental factors were associated with SLE, including birth conditions, sweet food, cooking oil, taste, fruit consumption, sunlight exposure, quality of sleep, physical activities, drinking water, residence, negative life events, hepatitis B vaccine, age of menarche, and age at birth of first child (P < 0.05). Our large population-based epidemiological survey estimated the prevalence of SLE at 37.56 per 100,000 persons. Multiple environmental factors were associated with the development of SLE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ye DQ (2006) Systemic lupus erythematosus, 1st edn. People’s Health Publishing House, Beijing

    Google Scholar 

  2. Hess EV, Farhey Y (1995) Etiology, environmental relationships, epidemiology, and genetics of systemic lupus erythematosus. Curr Opin Rheumatol 7:371–375

    Article  CAS  PubMed  Google Scholar 

  3. Manzi S (2001) Epidemiology of systemic lupus erythematosus. Am J Manag Care 7:S474–S479

    CAS  PubMed  Google Scholar 

  4. Siegel M, Lee SL (1973) The epidemiology of systemic lupus erythematosus. Semin Arthr Rheum 3:1–54

    Article  CAS  Google Scholar 

  5. Borchers AT, Naguwa SM, Shoenfeld Y et al (2010) The geoepidemiology of systemic lupus erythematosus. Autoimmun Rev 9:A277–A287

    Article  CAS  PubMed  Google Scholar 

  6. Pons-Estel GJ, Alarcón GS, Scofield L et al (2010) Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthr Rheum 39:257–268

    Article  Google Scholar 

  7. Osio-Salido E, Manapat-Reyes H (2010) Epidemiology of systemic lupus erythematosus in Asia. Lupus 19:1365–1373

    Article  CAS  PubMed  Google Scholar 

  8. Zeng QY, Chen R, Darmawan J et al (2008) Rheumatic diseases in China. Arthr Res Ther 10:R17

    Article  Google Scholar 

  9. Dai SM, Han XH, Zhao DB et al (2003) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study. J Rheumatol 30:2245–2251

    PubMed  Google Scholar 

  10. Chou CT, Pei L, Chang DM et al (1994) Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol 21:302–306

    CAS  PubMed  Google Scholar 

  11. Mok CC, Lau CS (2003) Lupus in Hong Kong Chinese. Lupus 12:717–722

    Article  CAS  PubMed  Google Scholar 

  12. Mok C (2011) Epidemiology and survival of systemic lupus erythematosus in Hong Kong Chinese. Lupus 20:767–771

    Article  CAS  PubMed  Google Scholar 

  13. Chiu YM, Lai CH (2010) Nationwide population-based epidemiologic study of systemic lupus erythematosus in Taiwan. Lupus 19:1250–1255

    Article  PubMed  Google Scholar 

  14. Cooper GS, Wither J, Bernatsky S et al (2010) Occupational and environmental exposures and risk of systemic lupus erythematosus: silica, sunlight, solvents. Rheumatology 49:2172–2180

    Article  CAS  PubMed  Google Scholar 

  15. Dooley MA, Hogan SL (2003) Environmental epidemiology and risk factors for autoimmune disease. Curr Opin Rheumatol 15:99–103

    Article  CAS  PubMed  Google Scholar 

  16. Peng CL, Jiang F, Wang BT et al (2010) Interactions between susceptible genes and risk environmental factors in Chinese females with systemic lupus erythematosus. Zhonghua Yu Fang Yi Xue Za Zhi 44:144–149

    CAS  PubMed  Google Scholar 

  17. Ye DQ, Hu YS, Li XP et al (2004) Influences of environmental factors and interaction of several chemokines gene-environmental on systemic lupus erythematosus. Zhonghua Liu Xing Bing Xue Za Zhi 25:949–953

    PubMed  Google Scholar 

  18. Huang LS (2002) The census 2000 in Anhui Province, 1st edn. China Statistics Press, Beijing

    Google Scholar 

  19. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthr Rheum 40:1725

    Article  CAS  Google Scholar 

  20. Jiménez S, Cervera R, Font J et al (2003) The epidemiology of systemic lupus erythematosus. Clin Rev Allergy Immunol 25:3–12

    Article  PubMed  Google Scholar 

  21. Cervera R, Khamashta MA, Font J et al (1993) Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on systemic lupus erythematosus. Medicine 72:113–124

    Article  CAS  PubMed  Google Scholar 

  22. Gudmundsson S, Steinsson K (1990) Systemic lupus erythematosus in Iceland 1975 through 1984. A nationwide epidemiological study in an unselected population. J Rheumatol 17:1162–1167

    CAS  PubMed  Google Scholar 

  23. Jonsson H, Nived O, Sturfelt G et al (1990) Estimating the incidence of systemic lupus erythematosus in a defined population using multiple sources of retrieval. Br J Rheumatol 29:185–188

    Article  CAS  PubMed  Google Scholar 

  24. Hochberg MC, Perlmutter DL, Medsger TA et al (1995) Prevalence of self-reported physician-diagnosed systemic lupus erythematosus in the USA. Lupus 4:454–456

    Article  CAS  PubMed  Google Scholar 

  25. Washio M, Horiuchi T, Kiyohara C et al (2006) Smoking, drinking, sleeping habits, and other lifestyle factors and the risk of systemic lupus erythematosus in Japanese females: findings from the KYSS study. Mod Rheumatol 16:143–150

    Article  PubMed  Google Scholar 

  26. Yacoub Wasef SZ (2004) Gender differences in systemic lupus erythematosus. Gend Med 1:12–17

    Article  PubMed  Google Scholar 

  27. Ghaussy NO, Sibbitt WL Jr, Qualls CR (2001) Cigarette smoking, alcohol consumption, and the risk of systemic lupus erythematosus: a case-control study. J Rheumatol 28:2449–2453

    CAS  PubMed  Google Scholar 

  28. Wang J, Pan HF, Ye DQ et al (2008) Moderate alcohol drinking might be protective for systemic lupus erythematosus: a systematic review and meta-analysis. Clin Rheumatol 27:1557–1563

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are indebted to Dr De-Guang Wang, the Second Affiliated Hospital of Anhui Medical University, for assistance in case identification. We thank Jian-Jun Liu, Anhui Medical University, for his editorial support and assistance in preparing the manuscript. We also thank Min Gao, Jing Tian, Jie Yang, Ye Fan, Jing Li, Se-Ying Dai, Man-Man Lu, Wen-Xian Li, Ning Zhang, Min Tian, Lei Ding, Song Wang, Zhang-Jun Huang, Yan Ma, Juan Wang, Li-Li Chen, Ruo-Jie Li, Chao Wang, Wei-Zi Qin, Zhen-Qiu Zha, Lei Xue, Wei-Wei Hu, Wang-Dong Xu, Mo Zhou, Hui Peng, Yu-Jing Zhang, Ke Xu, Wei Wang, Shan-Shan Liu, Yu Zhai, Hai-Rong Liu, Yan Zhu, Juan Liu, Mei Yang, Peng-Fei Wen, Kao-Kao Zhu, Min Zhang, Lin-Feng Hu, Xiao-Song Wang, Lian-Hong Li, Hui Yuan, Li-Wei Zhu, and Hong Chen, students of Anhui Medical University, for assistance in data collection. Their cooperation was invaluable to this research. We also express great thanks to all the study subjects for their participation. The study was supported by grants from the National Natural Science Foundation of China (30830089, 81172764, 81001283, 81102192). The funding source had no role in study design, data collection, data analysis, data interpretation, or writing of the article.

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, People’s Republic of China

    Yan-Feng Zou, Chen-Chen Feng, Ji-Min Zhu, Gui-Mei Chen, Han Cen, Rui-Xue Leng, Fa-Ming Pan, Hai-Feng Pan, Rui Li, Yin-Guang Fan, Bin Wang & Dong-Qing Ye

  2. Anhui Provincial Laboratory of Population Health and Major Disease Screening and Diagnosis, 81 Meishan Road, Hefei, 230032, Anhui, People’s Republic of China

    Yan-Feng Zou, Chen-Chen Feng, Ji-Min Zhu, Gui-Mei Chen, Han Cen, Rui-Xue Leng, Fa-Ming Pan, Hai-Feng Pan, Rui Li, Yin-Guang Fan, Bin Wang & Dong-Qing Ye

  3. Department of Rheumatology, Anhui Provincial Hospital, 17 Lujiang Road, Hefei, 230001, Anhui, People’s Republic of China

    Jin-Hui Tao & Xiang-Pei Li

  4. Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, Anhui, People’s Republic of China

    Qian-Ling Ye

  5. State Laboratory Incubation Base on Dermatology, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People’s Republic of China

    Feng-Yu Zhang

  6. Department of Public Health and General Medicine, School of Integrated Traditional and Western Medicine, Anhui University of Traditional Chinese Medicine, Hefei, 230038, Anhui, People’s Republic of China

    Ji-Min Zhu

Authors
  1. Yan-Feng Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chen-Chen Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ji-Min Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jin-Hui Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gui-Mei Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qian-Ling Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Han Cen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rui-Xue Leng
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fa-Ming Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hai-Feng Pan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Rui Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yin-Guang Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Bin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Xiang-Pei Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Feng-Yu Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Dong-Qing Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dong-Qing Ye.

Additional information

Y.-F. Zou, C.-C. Feng, J.-M. Zhu and J.-H. Tao contributed equally to this work.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 184 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zou, YF., Feng, CC., Zhu, JM. et al. Prevalence of systemic lupus erythematosus and risk factors in rural areas of Anhui Province. Rheumatol Int 34, 347–356 (2014). https://doi.org/10.1007/s00296-013-2902-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-013-2902-1

Keywords

Search

Navigation