The Geospatial Distribution of Myositis and Its Phenotypes in the United States and Associations With Roadways: Findings From a National Myositis Patient Registry

Md M Hossain; Jesse Wilkerson; John A McGrath; Payam N Farhadi; Cole Brokamp; Md T F Khan; Bob Goldberg; Hermine I Brunner; Maurizio Macaluso; Frederick W Miller; Lisa G Rider

doi:10.3389/fmed.2022.842586

The Geospatial Distribution of Myositis and Its Phenotypes in the United States and Associations With Roadways: Findings From a National Myositis Patient Registry

Front Med (Lausanne). 2022 Mar 16:9:842586. doi: 10.3389/fmed.2022.842586. eCollection 2022.

Authors

Md M Hossain^{1

2}, Jesse Wilkerson³, John A McGrath³, Payam N Farhadi^{4

5}, Cole Brokamp^{1

2}, Md T F Khan⁶, Bob Goldberg⁷, Hermine I Brunner^{2

8}, Maurizio Macaluso^{1

2}, Frederick W Miller⁴, Lisa G Rider⁴

Affiliations

¹ Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, OH, United States.
² Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
³ Social and Scientific Systems, A DLH Holdings Corp Company, Durham, NC, United States.
⁴ Environmental Autoimmunity Group, Clinical Research Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States.
⁵ Kelly Government Solutions, Rockville, MD, United States.
⁶ Division of Biostatistics and Bioinformatics, University of Cincinnati, Cincinnati, OH, United States.
⁷ The Myositis Association, Alexandria, VA, United States.
⁸ Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.

Abstract

Background: Little is known about the spatial distribution of idiopathic inflammatory myopathies (IIM) in the United States (U.S.), or their geospatial associations.

Methods: We studied a national myositis patient registry, with cases diagnosed in the contiguous U.S. from 1985-2011 and comprised of dermatomyositis (DM, n = 484), polymyositis (PM, n = 358), and inclusion body myositis (IBM, n = 318) patients. To assess the association of myositis prevalence with distance from roads, we employed log-Gaussian Cox process models, offset with population density.

Results: The U.S. IIM case distribution demonstrated a higher concentration in the Northest. DM, IBM, and cases with lung disease were more common in the East, whereas PM cases were more common in the Southeast. One area in the West and one area in the South had a significant excess in cases of DM relative to PM and of cases with lung disease relative to those without lung disease, respectively. IIM cases tended to cluster, with between-points interactions more intense in the Northeast and less in the South. There was a trend of a higher prevalence of IIM and its major phenotypes among people living within 50 m of a roadway relative to living beyond 200 m. Demographic characteristics, rural-urban commuting area, and female percentage were significantly associated with the prevalence of IIM and with major phenotypes.

Conclusions: Using a large U.S. database to evaluate the spatial distribution of IIM and its phenotypes, this study suggests clustering in some regions of the U.S. and a possible association of proximity to roadways.

Keywords: cluster; log-Gaussian Cox process; major or minor road networks; myositis; prevalence.