--- title: "SLE and race disparities in risk of co-morbid conditions. | Sutter Health" description: "SLE status does not independently confer substantial interaction by race/ethnicity toward the risk of pneumonia, other infections, CVD, neoplasms." url: "https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. SLE and race disparities in risk of co-morbid conditions. # Does SLE widen or narrow race/ethnic disparities in the risk of five co-morbid conditions? Evidence from a community-based outpatient care system. Falasinnu T, Chaichian Y, Li J, Chung S, Waitzfelder BE, Fortmann SP, Palaniappan L, & Simard JF. _Lupus. 28(14):1619-1627. doi: 10.1177/0961203319884646. Epub 2019 Oct 29._ 2019-12-01 ## Abstract OBJECTIVE: The heterogeneous spectrum of systemic lupus erythematosus (SLE) often presents with secondary complications such as cardiovascular disease (CVD), infections and neoplasms. Our study assessed whether the presence of SLE independently increases or reduces the disparities, accounting for the already higher risk of these outcomes among racial/ethnic minority groups without SLE. METHODS: We defined a cohort using electronic health records data (2005-2016) from a mixed-payer community-based outpatient setting in California serving patients of diverse racial/ethnic backgrounds. The eligible population included adult patients with SLE and matched non-SLE patients (≥18 years old). SLE was the primary exposure. The following outcomes were identified: pneumonia, other infections, CVD and neoplasms. For each racial/ethnic group, we calculated the proportion of incident co-morbidities by SLE exposure, followed by logistic regression for each outcome with SLE as the exposure. We evaluated interaction on the additive and multiplicative scales by calculating the relative excess risk due to interaction and estimating the cross-product term in each model. RESULTS: We identified 1036 SLE cases and 8875 controls. The incidence for all outcomes was higher among the SLE exposed. We found little difference in the odds of the outcomes associated with SLE across racial/ethnic groups, even after multivariable adjustment. This finding was consistent on the multiplicative and additive scales. CONCLUSION: We demonstrated that SLE status does not independently confer substantial interaction or heterogeneity by race/ethnicity toward the risk of pneumonia, other infections, CVD or neoplasms. Further studies in larger datasets are necessary to validate this novel finding. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/31660790/) ![Jiang Li, Ph.D., MPH](https://dyn.mktgcdn.com/p/H4OFJqNxBzDqkSWaIqDBiZgqIsHNsHLWdLuMd9IlNx0/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Jiang Li, Ph.D., MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Infectious Disease](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Infectious+Disease%5C%22%22) - [Lung Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lung+Diseases%5C%22%22) - [Lupus](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Lupus%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Precision lifestyle medicine: a new frontier in the science of behavior change and population health.](https://www.sutterhealth.org/research/publications/precision-lifestyle-medicine-1055312346) Ma J, Rosas LG, Lv N. Am J Prev Med. pii: S0749-3797(15)00638-8. doi: 10.1016/j.amepre.2015.09.035. \[Epub ahead of print\] 2015 Dec 01 - Publication ### [Disseminated tuberculosis and lung cancer associated with infliximab treatment of rheumatoid arthritis.](https://www.sutterhealth.org/research/publications/tb-lung-cancer-infliximab-tx-rheumatoid-arthritis-1055312877) Sankaranarayanan Viji, Krishna G, Gould M, Chitkara R. Clin Pulmon Med.12(2):115-120. 2005 Mar 01 - Publication ### [The burden of cancer in Asian Americans: a report of national mortality trends by Asian ethnicity.](https://www.sutterhealth.org/research/publications/cancer-asian-ams-natl-mortality-trends-by-grps-1055312524) Thompson CA, Gomez SL, Hastings KG, Kapphahn K, Yu P, Shariff-Marco S, Bhatt AS, Wakelee HA, Patel MI, Cullen MR, Palaniappan LP. Cancer Epidemiol Biomarkers Prev. 25(10):1371-1382. 2016 Oct 01 - Publication ### [Thoracic aorta calcification and noncardiovascular disease-related mortality: the multi-ethnic study of atherosclerosis.](https://www.sutterhealth.org/research/publications/thoracic-aorta-calcification-and-non-cvd-mortality-1055312467) Thomas IC, Thompson CA, Yang M, Allison MA, Forbang NI, Michos ED, McClelland RL, Budoff MJ, Criqui MH. Arterioscler Thromb Vasc Biol. pii: ATVBAHA.118.310850. doi: 10.1161/ATVBAHA.118.310850. \[Epub ahead of print\] 2018 Jun 28 - Publication ### [Provider perspectives on advance care planning documentation in the electronic health record.](https://www.sutterhealth.org/research/publications/providers-on-advance-care-plans-ehr-1055312324) Dillon E, Chuang J, Gupta A, Tapper S, Lai S, Yu P, Ritchie C, Tai-Seale M. Am J Hosp Palliat Care. 1049909117693578. doi: 10.1177/1049909117693578. \[Epub ahead of print\] 2017 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"SLE and race disparities in risk of co-morbid conditions."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829#medicalscholarlyarticle","name":"Does SLE widen or narrow race/ethnic disparities in the risk of five co-morbid conditions? Evidence from a community-based outpatient care system.","headline":"SLE and race disparities in risk of co-morbid conditions.","abstract":"OBJECTIVE: The heterogeneous spectrum of systemic lupus erythematosus (SLE) often presents with secondary complications such as cardiovascular disease (CVD), infections and neoplasms. Our study assessed whether the presence of SLE independently increases or reduces the disparities, accounting for the already higher risk of these outcomes among racial/ethnic minority groups without SLE. METHODS: We defined a cohort using electronic health records data (2005-2016) from a mixed-payer community-based outpatient setting in California serving patients of diverse racial/ethnic backgrounds. The eligible population included adult patients with SLE and matched non-SLE patients (≥18 years old). SLE was the primary exposure. The following outcomes were identified: pneumonia, other infections, CVD and neoplasms. For each racial/ethnic group, we calculated the proportion of incident co-morbidities by SLE exposure, followed by logistic regression for each outcome with SLE as the exposure. We evaluated interaction on the additive and multiplicative scales by calculating the relative excess risk due to interaction and estimating the cross-product term in each model. RESULTS: We identified 1036 SLE cases and 8875 controls. The incidence for all outcomes was higher among the SLE exposed. We found little difference in the odds of the outcomes associated with SLE across racial/ethnic groups, even after multivariable adjustment. This finding was consistent on the multiplicative and additive scales. CONCLUSION: We demonstrated that SLE status does not independently confer substantial interaction or heterogeneity by race/ethnicity toward the risk of pneumonia, other infections, CVD or neoplasms. Further studies in larger datasets are necessary to validate this novel finding.","description":"SLE status does not independently confer substantial interaction by race/ethnicity toward the risk of pneumonia, other infections, CVD, neoplasms.","keywords":["All Cancer","Cardiovascular Diseases","Health Disparities","Infectious Disease","Lung Diseases","Lupus"],"datePublished":"2019-12-01","url":"https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"31660790"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1177/0961203319884646"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/31660790/","https://doi.org/10.1177/0961203319884646"],"isPartOf":{"@type":"Periodical","name":"Lupus"},"author":[{"@type":"Person","name":"Falasinnu T"},{"@type":"Person","name":"Chaichian Y"},{"@type":"Person","@id":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008","name":"Li J","url":"https://www.sutterhealth.org/research/investigators/jiang-li-phd-mph-1049681008"},{"@type":"Person","name":"Chung S"},{"@type":"Person","name":"Waitzfelder BE"},{"@type":"Person","name":"Fortmann SP"},{"@type":"Person","name":"Palaniappan L"},{"@type":"Person","name":"Simard JF"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"All Cancer","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22All+Cancer%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Infectious Disease","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Infectious+Disease%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Lung Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Lung+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Lupus","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Lupus%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/sle-and-race-disparities-in-risk-of-co-morbid-conditions-1055312829#breadcrumblist"}}} ```