Related Experiment Videos
Racial differences in scleroderma among women in Michigan
T J Laing1, B W Gillespie, M B Toth
1University of Michigan and the Multipurpose Arthritis and Musculoskeletal Disease Center, Ann Arbor, USA.
Arthritis and Rheumatism
|April 1, 1997
Summary
Black women with scleroderma present with diffuse disease and higher inflammatory markers at a younger age, leading to poorer age-adjusted survival compared to white women. This highlights significant racial disparities in scleroderma (systemic sclerosis) outcomes.
Area of Science:
- Rheumatology
- Immunology
- Epidemiology
Background:
- Scleroderma, also known as systemic sclerosis, is a chronic autoimmune disease characterized by hardening and tightening of the skin and connective tissues.
- Racial and ethnic variations in scleroderma prevalence, clinical presentation, and outcomes are increasingly recognized, necessitating further investigation.
Purpose of the Study:
- To investigate racial disparities in the onset, extent, clinical manifestations, and survival rates of scleroderma among women.
- To compare the incidence and clinical characteristics of scleroderma between black and white women in Michigan.
Main Methods:
- A retrospective cohort study analyzed data from 514 women diagnosed with scleroderma in Michigan between 1980 and 1991.
- Medical records were reviewed to abstract demographic, clinical, and laboratory data.
Main Results:
- Black women (23%) were diagnosed at a younger age (44.5 years) with more frequent diffuse disease (49.6%) compared to white women (51.5 years, 24.9%).
- Higher incidence rates were observed in black women (22.5/million/year) versus white women (12.8/million/year).
- Black women showed increased rates of pericarditis, pulmonary hypertension, pleural effusions, myositis, and elevated ESR, while white women had more digital infarctions. Seven-year survival was 72.5% for black women versus 77.6% for white women, with significantly reduced age-adjusted survival in black women (P=0.033).
Conclusions:
- Black women with scleroderma experience earlier disease onset, a higher prevalence of diffuse disease, and increased inflammatory features.
- These factors contribute to a worse age-adjusted survival rate in black women compared to white women with scleroderma.
- Racial disparities significantly impact scleroderma outcomes, particularly in relation to diffuse disease and organ involvement.