Department of Internal Medicine, Section of Rheumatology and Immunology, 986270 Nebraska Medical Center, Omaha, NE 68198-6270, USA.
Ann Rheum Dis. 2010 Jul;69(7):1292-7. doi: 10.1136/ard.2009.122739. Epub 2010 May 3.
To examine associations of anti-cyclic citrullinated peptide (aCCP) antibody and rheumatoid factor (RF) concentrations with future disease activity in men with rheumatoid arthritis (RA).
Outcome measures were examined in male US veterans with RA and included (1) proportion of observations in remission (disease activity score (DAS28) < or =2.6); (2) remission for > or =3 consecutive months; and (3) area under the curve (AUC) for DAS28. The associations of autoantibody concentration (per 100 unit increments) with outcomes were examined using multivariate regression.
826 men with RA were included in the analysis; the mean (SD) age was 65 (10.5) years and follow-up was for 2.6 (1.3) years. Most were aCCP (75%) and RF (80%) positive. After multivariate adjustment, aCCP (OR 0.93; 95% CI 0.89 to 0.96) and RF concentrations (OR 0.92; 95% CI 0.90 to 0.94) were associated with a lower odds of remission, a lower proportion of observation in remission (p=0.017 and p=0.002, respectively) and greater AUC DAS28 (p=0.092 and p=0.007, respectively). Among patients with discordant autoantibody status, higher concentrations of both aCCP and RF trended towards an inverse association with remission (OR 0.93; 95% CI 0.83 to 1.05 and OR 0.80; 95% CI 0.59 to 1.10, respectively).
Higher aCCP concentrations (particularly in RF-positive patients) are associated with increased disease activity in US veterans with RA, indicating that aCCP concentration is predictive of future disease outcomes in men.
探讨抗环瓜氨酸肽（aCCP）抗体和类风湿因子（RF）浓度与男性类风湿关节炎（RA）患者未来疾病活动的相关性。
对美国退伍军人中患有 RA 的男性患者进行了结局指标检查，包括（1）缓解（疾病活动评分（DAS28）≤2.6）的观察比例；（2）连续 3 个月以上的缓解；（3）DAS28 的曲线下面积（AUC）。使用多元回归分析了自身抗体浓度（每增加 100 个单位）与结局的相关性。
共纳入 826 例 RA 男性患者，平均（SD）年龄为 65（10.5）岁，随访时间为 2.6（1.3）年。大多数患者 aCCP（75%）和 RF（80%）阳性。经多变量调整后，aCCP（OR 0.93；95%CI 0.89 至 0.96）和 RF 浓度（OR 0.92；95%CI 0.90 至 0.94）与缓解的可能性降低、缓解的观察比例降低（p=0.017 和 p=0.002，分别）和更大的 AUC DAS28（p=0.092 和 p=0.007，分别）相关。在自身抗体状态不一致的患者中，较高浓度的 aCCP 和 RF 均与缓解呈负相关趋势（OR 0.93；95%CI 0.83 至 1.05 和 OR 0.80；95%CI 0.59 至 1.10，分别）。
较高的 aCCP 浓度（尤其是在 RF 阳性患者中）与美国退伍军人中 RA 患者的疾病活动增加相关，这表明 aCCP 浓度可预测男性患者的未来疾病结局。
