Association of Short-Term Ultraviolet Radiation Exposure and Disease Severity in Juvenile Dermatomyositis: Results From the Childhood Arthritis and Rheumatology Research Alliance Legacy Registry.
Calcinosis
/ diagnosis
Child
Child, Preschool
Cross-Sectional Studies
Dermatomyositis
/ diagnosis
Disease Progression
Environmental Exposure
/ adverse effects
Female
Follow-Up Studies
Humans
Incidence
Male
Prognosis
Registries
Retrospective Studies
Rheumatology
Risk Factors
Severity of Illness Index
Skin
/ pathology
Ultraviolet Rays
/ adverse effects
United States
/ epidemiology
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
12 2019
12 2019
Historique:
received:
25
10
2018
accepted:
29
01
2019
pubmed:
5
2
2019
medline:
14
4
2020
entrez:
5
2
2019
Statut:
ppublish
Résumé
Ultraviolet (UV) radiation is considered to be an important environmental factor in the clinical course of children with juvenile dermatomyositis (DM). We aimed to evaluate the association between UV radiation and severe disease outcomes in juvenile DM. This is a cross-sectional study of patients with juvenile DM enrolled in the US multicenter Childhood Arthritis and Rheumatology Research Alliance (CARRA) Legacy Registry from 2010 to 2015. The mean UV index (UVI) in the calendar month prior to symptom onset in each subject's zip code was calculated from daily satellite solar noon measurements. Multivariable logistic regression was used to model the relationship between the mean UVI and calcinosis as well as other outcomes of severe disease. Covariates included sex, race, age, time to diagnosis, disease duration, and latitude. In a multivariable model, there was no association between the mean UVI and calcinosis. African American race was associated with a 3-fold greater odds of calcinosis. However, there was a significant statistical interaction between race and mean UVI. Accounting for this interaction, the odds of calcinosis markedly decreased in African American subjects and steadily increased in non-African American subjects over a range of increasing the mean UVI. Higher mean UVI was associated with decreased odds of using biologics or nonmethotrexate disease-modifying antirheumatic drugs and skin ulceration. We described a novel association between UV radiation, calcinosis, and race in a large cohort of patients with juvenile DM. This study furthers our knowledge of the role of UV radiation in the clinical course of juvenile DM and highlights the complex interplay between genes and environment in the clinical phenotypes and development of calcinosis in children with juvenile DM.
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1600-1605Subventions
Organisme : Childhood Arthritis & Rheumatology Research Alliance
ID : A131657
Pays : International
Organisme : NIAMS NIH HHS
ID : RC2 AR058934
Pays : United States
Investigateurs
L Abramson
(L)
E Anderson
(E)
M Andrew
(M)
N Battle
(N)
M Becker
(M)
H Benham
(H)
T Beukelman
(T)
J Birmingham
(J)
P Blier
(P)
A Brown
(A)
H Brunner
(H)
A Cabrera
(A)
D Canter
(D)
D Carlton
(D)
B Caruso
(B)
L Ceracchio
(L)
E Chalom
(E)
J Chang
(J)
P Charpentier
(P)
K Clark
(K)
J Dean
(J)
F Dedeoglu
(F)
B Feldman
(B)
P Ferguson
(P)
M Fox
(M)
K Francis
(K)
M Gervasini
(M)
D Goldsmith
(D)
G Gorton
(G)
B Gottlieb
(B)
T Graham
(T)
T Griffin
(T)
H Grosbein
(H)
S Guppy
(S)
H Haftel
(H)
D Helfrich
(D)
G Higgins
(G)
A Hillard
(A)
J R Hollister
(JR)
J Hsu
(J)
A Hudgins
(A)
C Hung
(C)
A Huttenlocher
(A)
N Ilowite
(N)
A Imlay
(A)
L Imundo
(L)
C J Inman
(CJ)
J Jaqith
(J)
R Jerath
(R)
L Jung
(L)
P Kahn
(P)
A Kapedani
(A)
D Kingsbury
(D)
K Klein
(K)
M Klein-Gitelman
(M)
A Kunkel
(A)
S Lapidus
(S)
S Layburn
(S)
T Lehman
(T)
C Lindsley
(C)
M MacgregorHannah
(M)
M Malloy
(M)
C Mawhorter
(C)
D McCurdy
(D)
K Mims
(K)
N Moorthy
(N)
D Morus
(D)
E Muscal
(E)
M Natter
(M)
J Olson
(J)
K O'Neil
(K)
K Onel
(K)
M Orlando
(M)
J Palmquist
(J)
M Phillips
(M)
L Ponder
(L)
S Prahalad
(S)
M Punaro
(M)
D Puplava
(D)
S Quinn
(S)
A Quintero
(A)
C Rabinovich
(C)
A Reed
(A)
C Reed
(C)
S Ringold
(S)
M Riordan
(M)
S Roberson
(S)
A Robinson
(A)
J Rossette
(J)
D Rothman
(D)
D Russo
(D)
N Ruth
(N)
K Schikler
(K)
A Sestak
(A)
B Shaham
(B)
Y Sherman
(Y)
M Simmons
(M)
N Singer
(N)
S Spalding
(S)
H Stapp
(H)
R Syed
(R)
E Thomas
(E)
K Torok
(K)
D Trejo
(D)
J Tress
(J)
W Upton
(W)
R Vehe
(R)
E von Scheven
(E)
L Walters
(L)
J Weiss
(J)
P Weiss
(P)
N Welnick
(N)
A White
(A)
J Woo
(J)
J Wootton
(J)
A Yalcindag
(A)
C Zapp
(C)
L Zemel
(L)
A Zhu
(A)
Informations de copyright
© 2019, American College of Rheumatology.
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