Parikh-Patel Arti, Gold Ellen, Utts Jessica, Gershwin M Eric
Department of Statistics and Epidemiology, University of California at Davis, Davis, CA 95616, USA.
Ann Epidemiol. 2002 May;12(4):264-72. doi: 10.1016/s1047-2797(01)00277-0.
Primary biliary cirrhosis is an autoimmune disease with female predominance that leads to liver failure. The goal of this study was to identify reproductive risk factors associated with this disease.
We compared 182 cases of PBC with 225 age- and sex-matched friend controls to examine the role of reproductive factors. The survey instrument was developed using standardized questions obtained from the National Health and Nutrition Examination Survey (NHANES) III.
A total of 126/182 cases (69%) and 141/225 (62.6%) friend controls responded to the survey. More cases than controls reported ever having genitourinary infection [adjusted odds ratio (OR) = 2.12, 95% confidence interval (CI) 1.01, 4.42] among those without a personal or family history of autoimmune disease. The most notable finding was that cases reported significantly more pregnancies than controls (p = 0.008). The adjusted OR for each additional pregnancy among those without a personal or family history of autoimmune disease was 1.40 (95% CI 1.14, 1.7). More controls (24.4%) than cases (16.0%) were nulliparous. Cases reported having five or more children (16.0%) with double the frequency of controls (8.2%).
The association reported herein, between primary biliary cirrhosis and gravidity, is particularly significant because of the overwhelming female predominance.
原发性胆汁性肝硬化是一种以女性为主的自身免疫性疾病，可导致肝功能衰竭。本研究的目的是确定与该疾病相关的生殖风险因素。
我们将182例原发性胆汁性肝硬化患者与225名年龄和性别匹配的朋友对照进行比较，以研究生殖因素的作用。调查工具是根据从美国国家健康和营养检查调查（NHANES）III获得的标准化问题开发的。
共有126/182例（69%）患者和141/225例（62.6%）朋友对照回应了调查。在没有自身免疫性疾病个人或家族史的人群中，报告有泌尿生殖系统感染的患者比对照更多[调整后的优势比（OR）=2.12，95%置信区间（CI）1.01，4.42]。最显著的发现是，患者报告的怀孕次数明显多于对照（p = 0.008）。在没有自身免疫性疾病个人或家族史的人群中，每增加一次怀孕的调整后OR为1.40（95%CI 1.14，1.7）。未生育的对照（24.4%）比患者（16.0%）更多。患者报告生育五个或更多孩子的比例（16.0%）是对照（8.2%）的两倍。
本文报道的原发性胆汁性肝硬化与妊娠之间的关联尤为显著，因为女性占绝大多数。
