Objective To describe the disease characteristics of osteonecrosis of the femoral head (ONFH) in patients with systemic lupus erythematosus (SLE) who experiencing prolonged glucocorticoid (GC) exposure. Methods Between January 2016 and June 2019, 449 SLE patients meeting the criteria were recruited from multiple centers. Hip MRI examinations were performed during screening and regular follow-up to determine the occurrence of ONFH. The cohort was divided into ONFH and non-ONFH groups, and the differences in demographic baseline characteristics, general clinical characteristics, GC medication information, combined medication, and hip clinical features were compared and comprehensively described. ResultsThe age at SLE diagnosis was 29.8 (23.2, 40.9) years, with 93.1% (418 cases) being female. The duration of GC exposure was 5.3 (2.0, 10.5) years, and the cumulative incidence of SLE-ONFH was 9.1%. Significant differences (P<0.05) between ONFH and non-ONFH groups were observed in the following clinical characteristics: ① Demographic baseline characteristics: ONFH group had a higher proportion of patients with body mass index (BMI)<20 kg/m2 compared to non-ONFH group. ② General clinical characteristics: ONFH group showed a higher proportion of patients with cutaneous and renal manifestations, positive antiphospholipid antibodies (aPLs) and anticardiolipin antibodies, severe SLE patients [baseline SLE Disease Activity Index 2000 (SLEDAI-2K) score ≥15], and secondary hypertension. Fasting blood glucose in ONFH group was also higher. ③ GC medication information: ONFH group had higher initial intravenous GC exposure rates, duration, cumulative doses, higher cumulative GC doses in the first month and the first 3 months, higher average daily doses in the first 3 months, and higher proportions of average daily doses ≥15.0 mg/d and ≥30.0 mg/d, as well as higher full-course average daily doses and proportion of full-course daily doses ≥30.0 mg/d compared to non-ONFH group. ④ Combined medications: ONFH group had a significantly higher rate of antiplatelet drug use than non-ONFH group. ⑤ Hip clinical features: ONFH group had a higher proportion of hip discomfort or pain and a higher incidence of hip joint effusion before MRI screening than non-ONFH group. Conclusion The incidence of ONFH after GC exposure in China’s SLE population remains high (9.1%), with short-term (first 3 months), medium-to-high dose (average daily dose ≥15 mg/d) GC being closely associated with ONFH. Severe SLE, low BMI, certain clinical phenotypes, positive aPLs, and secondary hypertension may also be related to ONFH.
Objective To investigate the rate of pulmonary function test, medication treatment, and relevant factors among patients with chronic obstructive pulmonary disease (COPD) aged 40 years or older in community of Guangdong Province, and to provide evidences for targeted intervention of COPD. Methods A multistage stratified cluster sampling was conducted in the community residents, who participated in the COPD surveillance project of in Guangdong Province during 2019 to 2020. A total of 3384 adults completed questionnaire and pulmonary function test. The Rao-Scott χ2 test based on complex sampling design, and non-conditional Logistic regression were used to explore possible influencing factors of pulmonary function test and medication treatment in COPD patients. Results Out of the 3384 adults, 288 patients with COPD were confirmed, including 253 males (87.8%) and 35 females (12.2%), and 184 patients (60.4%) were over 60 years old or more. The pulmonary function test rate was 10.7% [95% confidence interval (CI) 6.8% - 14.6%], and medication treatment rate was 10.6% (95%CI 7.0% - 14.1%). The results showed that wheezing, awareness of COPD related knowledge and pulmonary function test were related to whether COPD patients had pulmonary function test (P<0.05). Wheezing and personal history of respiratory diseases were related to medication treatment rate (P<0.05). Conclusions The rates of pulmonary function test and medication treatment among COPD patients aged 40 years or older are low. Health education about COPD should be actively carried out, and the screening of individuals with a history of respiratory diseases and respiratory symptoms should be strengthened so as to reduce the burden of COPD diseases.