Epidemiology of eight common rheumatic diseases in China: a large-scale cross-sectional survey in Beijing.
ABSTRACT To investigate the prevalence of eight common rheumatic diseases in a large Chinese population.
A population-based epidemiological investigation of the prevalence of eight common rheumatic diseases in a suburb of Beijing was conducted in 14 642 individuals. A community-based survey was carried out using a screening questionnaire. Positive responders were included in a clinical and laboratory examination. Diagnosis was based on the criteria of ACR or those used widely in literature.
A total of 10 556 inhabitants were interviewed. Forty-three cases of RA were identified with an age-adjusted prevalence of 0.28% (95% CI 0.19%, 0.41%). Gout was diagnosed with a crude prevalence of 0.09% (95% CI 0.05%, 0.17%). Psoriasis was reported in 28 individuals with a prevalence of 0.27% (95% CI 0.18%, 0.38%). This included two cases diagnosed with PsA, resulting in a prevalence of 7.14% (95% CI 0.88%, 23.5%) in psoriasis patients and 0.02% (95% CI 0%, 0.07%) in the general population. Three individuals were identified with SLE, with a prevalence of 0.03% (95% CI 0%, 0.06%). One individual was identified with SSc and the calculated prevalence was 0.01% (95% CI 0%, 0.05%). One case of Behçet's disease was identified, giving a prevalence of 0.01% (95% CI 0%, 0.05%).
This large-scale epidemiological survey provides an estimate of the burden of rheumatic diseases in China.
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ABSTRACT: Cutaneous lupus erythematosus (CLE) refers to those subtypes of lupus erythematosus (LE) that have predominantly skin manifestations. Discoid lupus erythematosus (DLE), subacute cutaneous lupus erythematosus (SCLE), LE panniculitis (LEP) and lupus erythematosus tumidus (LET) all fall into the category of CLE. The pathogenesis of CLE is likely multifactorial. UV irradiation has been shown to induce keratinocyte apoptosis. Impaired clearance of apoptotic cells is a potential mechanism for the development of CLE. UV irradiation can also induce externalization of autoantigens such as Ro/SSA, exposing them to circulating autoantibodies. Some drugs have been associated with CLE. Possible mechanisms include stimulation of an immune response through disruption of central tolerance and altered T cell function. T17 cells may also play a role in the pathogenesis of CLE as they have been detected in skin lesions of LE. Treg cells have been found to be decreased in LE lesions, which may contribute to the breakdown of self-tolerance. Epidermal Langerhans cells are reduced in CLE while plasmacytoid DCs are increased in the lesions of CLE, suggesting that DCs may also play an important role in the pathogenesis of CLE. Type I IFN- and TNF-α are both upregulated in lesions of CLE. Other cytokines such as IL-6 and IL-17 are also implicated in the pathogenesis of CLE. Cellular and cytokine networks can be impacted by environmental factors and genetic variations and this can result in an increased risk of developing autoimmune diseases such as CLE.Journal of Autoimmunity 02/2013; · 8.15 Impact Factor
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ABSTRACT: BACKGROUND: Few population-based studies have reported the prevalence of psoriatic disease. OBJECTIVE: We validated computerized diagnoses to estimate the prevalence of psoriasis and psoriatic arthritis. METHOD: We identified adults with ≥1 ICD-9 diagnosis codes of 696.0 (psoriatic arthritis) or 696.1 (psoriasis) in clinical encounter data during 1996-2009 and used chart review to confirm the diagnoses in random samples of patients. We then used the best performing case-finding algorithms to estimate the point prevalence of psoriasis and psoriatic arthritis. RESULTS: The number of persons with a diagnosis for psoriasis (ICD-9 code 696.1) was 87 827. Chart review of a random sample of 101 cases with at least one dermatologist-rendered psoriasis code revealed a positive predictive value (PPV) of 90% (95% CI, 83-95) with sensitivity of 88% (95% CI, 80-93). Psoriatic arthritis (code 696.0) was recorded for 5187 patients, with the best performing algorithm requiring ≥2 diagnoses recorded by a rheumatologist or ≥1 diagnosis recorded by a rheumatologist together with ≥1 psoriasis diagnoses recorded by a dermatologist; the PPV was 80% (95% CI, 70-88) with sensitivity 73% (95% CI, 63-82). Among KPNC adults, the point prevalence of psoriasis, with or without psoriatic arthritis, was 939 (95% CI, 765-1142) per 100 000, and the overall prevalence of psoriatic arthritis, with or without psoriasis, was 68 (95% CI, 54-84) per 100 000. CONCLUSION: Within an integrated health care delivery system, the use of computerized diagnoses rendered by relevant disease specialists is a valid method for identifying individuals with psoriatic disease. Copyright © 2013 John Wiley & Sons, Ltd.Pharmacoepidemiology and Drug Safety 05/2013; · 2.90 Impact Factor
Article: Spondyloarthritis in China.[show abstract] [hide abstract]
ABSTRACT: PURPOSE OF REVIEW: Although scientists in China have generated a considerable amount of new information about spondyloarthritis (SpA) in recent years, part of it was published in Chinese. The aim of this review is to summarize all SpA articles for the benefit of English readers. RECENT FINDINGS: In the field of epidemiology, prevalence of SpA in China has been updated, especially with regard to psoriatic arthritis (PsA). In the field of genetics, Chinese scientists have discovered new single-nucleotide polymorphism (SNP) sites association with ankylosing spondylitis (AS) in Han Chinese. In the field of treatment, tumour necrosis factor-alpha (TNF-α) antagonists are wildly used almost as a routine. The usefulness of certain Chinese traditional medicine is undergoing vigorous testing. In the field of diagnosis, ultrasound has been incorporated into the testing tools. In the field of monitoring of disease activity, Ankylosing Spondylitis Disease Activity Scores (ASDAS) has been validated in a cohort of Chinese SpA patients. SUMMARY: Chinese scientists are using cutting-edge technology in the fields of research, diagnosis and management in SpA. What is needed are new approaches that can accommodate the large variations in socioeconomic status of various localities in the vast Chinese continent.Current opinion in rheumatology 05/2013; · 4.60 Impact Factor