Satoh Minoru, Chan Edward K L, Ho Lindsey A, Rose Kathryn M, Parks Christine G, Cohn Richard D, Jusko Todd A, Walker Nigel J, Germolec Dori R, Whitt Irene Z, Crockett Patrick W, Pauley Brad A, Chan Jason Y F, Ross Steven J, Birnbaum Linda S, Zeldin Darryl C, Miller Frederick W
University of Florida, Gainesville, FL, USA.
Arthritis Rheum. 2012 Jul;64(7):2319-27. doi: 10.1002/art.34380.
To estimate the prevalence, types, and sociodemographic and biobehavioral correlates of antinuclear antibodies (ANAs) in the US.
We conducted a cross-sectional analysis of 4,754 individuals from the National Health and Nutrition Examination Survey 1999-2004. ANAs were assessed by indirect immunofluorescence. In ANA-positive individuals, cellular staining patterns were determined, and specific autoantibody reactivities were assessed by immunoprecipitation.
The ANA prevalence in the US population of individuals ages 12 years and older was 13.8% (95% confidence interval [95% CI] 12.2-15.5%). ANA prevalence increased with age (P=0.01), and ANAs were more prevalent among females than males (17.8% versus 9.6%; P<0.001), with the female-to-male ratio peaking at 40-49 years of age. ANA prevalence was modestly higher in African Americans compared with whites (age-adjusted prevalence odds ratio [POR] 1.30, 95% CI 1.00-1.70). Remarkably, ANAs were less common in overweight and obese individuals (age-adjusted POR 0.74) than in persons of normal weight. No significant associations of ANA with education, family income, alcohol use, smoking history, serum levels of cotinine, or C-reactive protein were observed. In ANA-positive individuals, nuclear patterns were seen in 84.6%, cytoplasmic patterns were seen in 21.8%, and nucleolar patterns were seen in 6.1%; the most common specific autoantibodies were anti-Ro (3.9%) and anti-Su (2.4%).
These findings suggest that more than 32 million persons in the US have ANAs, and that the prevalence is higher among females, older individuals, African Americans, and those with a normal body weight. These data will serve as a useful baseline for future investigations of predictors and changes in ANA prevalence over time.
评估美国抗核抗体（ANA）的患病率、类型以及社会人口统计学和生物行为学相关因素。
我们对1999 - 2004年国家健康和营养检查调查中的4754名个体进行了横断面分析。通过间接免疫荧光法评估ANA。在ANA阳性个体中，确定细胞染色模式，并通过免疫沉淀法评估特定自身抗体反应性。
在美国12岁及以上人群中，ANA患病率为13.8%（95%置信区间[95%CI] 12.2 - 15.5%）。ANA患病率随年龄增加而升高（P = 0.01），女性中的ANA患病率高于男性（17.8%对9.6%；P < 0.001），女性与男性的比例在40 - 49岁时达到峰值。与白人相比，非裔美国人的ANA患病率略高（年龄调整患病率比值比[POR] 1.30，95%CI 1.00 - 1.70）。值得注意的是，超重和肥胖个体中的ANA比正常体重个体少见（年龄调整POR 0.74）。未观察到ANA与教育程度、家庭收入、饮酒、吸烟史、可替宁血清水平或C反应蛋白之间存在显著关联。在ANA阳性个体中，核型占84.6%，胞质型占21.8%，核仁型占6.1%；最常见的特定自身抗体是抗Ro（3.9%）和抗Su（2.4%）。
这些发现表明，美国有超过3200万人患有ANA，且女性、老年人、非裔美国人以及正常体重者中的患病率更高。这些数据将为未来关于ANA患病率的预测因素及随时间变化的研究提供有用的基线。
