Quality of life disparities among Mexican people with systemic lupus erythematosus

PLOS Digit Health. 2025 Jan 23;4(1):e0000706. doi: 10.1371/journal.pdig.0000706. eCollection 2025 Jan.

Abstract

Higher prevalence and worst outcome have been reported among people with systemic lupus erythematosus with non-European ancestries, with both genetic and socioeconomic variables as contributing factors. In Mexico, studies assessing the inequities related to quality of life for Systemic Lupus Erythematosus patients remain sparse. This study aims to assess the inequities related to quality of life in a cohort of Mexican people with SLE. This study included 942 individuals with SLE from the Mexican Lupus Registry (LupusRGMX) and two healthy control groups. Self-answered surveys were collected via the Research Electronic Data Capture platform between May 2021 and January 2023. Data was analyzed as a cross-sectional study. A random forest model was implemented to assess potential predictive variables. Permutation tests were performed to analyze the effect health providers had on diagnosis lag and quality of life's differences among socioeconomic levels. Partial correlation analysis between the number of patients and rheumatologists registered was also performed. Systemic Lupus Erythematosus participants had significantly lower quality of life than healthy people (p-values < 0.0001). Socioeconomic status, delay in diagnosis, and corticosteroid consumption were the factors that influenced QoL the most (RMSE = 9.53 with the importance variable validated); lower quality of life was associated with lower socioeconomic status (p-value < 0.0001). Disparities in health services were reflected in longer diagnosis time among people with public health providers (p-value = 0.0419). A significant association between diagnosed patients and available rheumatologists by geographical state was observed (ρ = 0.4, p-value = 0.0259), which can be translated into restricted access to specialists. Since most of our cohort exhibited low socioeconomic status, it is important to consider them as a vulnerable population; this study settles the necessity to deepen the effects of the socioeconomic disparities, allowing to design public policies and strategies aimed to reduce Systemic Lupus Erythematosus disparities, therefore improving quality of life of Mexican people with Systemic Lupus Erythematosus.

Grants and funding

This project was supported by CONACYT-FORDECYT-PRONACES grant no. [11311] and [6390]. A.M.R. was supported by Programa de Apoyo a Proyectos de Investigación e Innovación Tecnológica–Universidad Nacional Autónoma de México (PAPIIT-UNAM) grants no. IA203021 and IN218023 and by Chan Zuckerberg Initiative Ancestry Network (2021-240438). A.L.H.L. is a doctoral student from Programa de Doctorado en Ciencias Biomédicas, Universidad Nacional Autónoma de México (UNAM). She received a fellowship CVU/Becario (711015/790972) from Consejo Nacional de Humanidades Ciencia y Tecnología (CONAHCYT). D.M. is a postdoctoral researcher supported by Consejo Nacional de Humanidades Ciencia y Tecnología (CONAHCYT), Estancias Posdoctorales por Mexico Convocatoria 2023(1), CVU 371892. M.E.R. thanks support from the Rebecca L Cooper Medical Research Foundation through an Al & Val Rosenstrauss Fellowship (F20231230). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.