Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.
Ann Med. 2012 May;44(3):289-95. doi: 10.3109/07853890.2010.547515. Epub 2011 Feb 1.
Although there are putative mechanistic links between obesity and autoimmune diseases, obesity is not considered a risk factor for most autoimmune diseases.
Using the nation-wide Hospital Discharge Register we defined a cohort of 29,665 patients hospitalized for obesity since year 1964. The patients were followed for hospitalization for any of 34 autoimmune or related conditions through year 2007. Standardized incidence ratios (SIRs) were calculated for autoimmune diseases in obese individuals compared to those who had not been hospitalized for obesity.
Among 22 immune diseases diagnosed after hospitalization for obesity and in at least 5 patients, the overall SIR was 2.05. Of the individual diseases studied, the risk of 16 was significantly increased; none displayed a decreased risk. Psoriasis (4.54) and Behçet's disease (4.49) exhibited the highest risks, followed by Hashimoto's disease/hypothyroidism (4.12) and asthma (3.39). Small but significant increases in SIRs were also noted for the common autoimmune diseases Graves's disease/hyperthyroidism (1.28) and rheumatoid arthritis (1.37).
The present population of obese individuals, subsequently diagnosed with a number of autoimmune diseases and related conditions, was hospitalized at a relatively young age. Further studies are needed to describe the morbidity in the obese population at large.
尽管肥胖与自身免疫性疾病之间存在潜在的机制联系,但肥胖并不被认为是大多数自身免疫性疾病的危险因素。
我们利用全国住院患者登记系统,定义了一个自 1964 年以来因肥胖住院的 29665 名患者的队列。通过 2007 年之前的任何一种 34 种自身免疫性或相关疾病的住院情况对患者进行随访。与未因肥胖住院的患者相比,计算肥胖患者患自身免疫性疾病的标准化发病比(SIR)。
在因肥胖住院后诊断出的 22 种免疫性疾病中,至少有 5 例患者确诊,总的 SIR 为 2.05。在所研究的个别疾病中,有 16 种疾病的风险显著增加;没有一种疾病的风险降低。银屑病(4.54)和贝赫切特病(4.49)风险最高,其次是桥本甲状腺炎/甲状腺功能减退症(4.12)和哮喘(3.39)。Graves 病/甲状腺功能亢进症(1.28)和类风湿关节炎(1.37)等常见自身免疫性疾病的 SIR 也略有显著增加。
目前,患有多种自身免疫性疾病和相关疾病的肥胖个体在相对年轻的时候就住院了。需要进一步研究来描述肥胖人群的发病率。