German Rheumatism Research Centre Berlin, A. Leibniz Institute, Berlin, Germany.
Clin Exp Rheumatol. 2013 Sep-Oct;31(5):796-802. Epub 2013 Apr 2.
This study aims to assess the prevalence of comorbidities in adult JIA and the impact of comorbidity on patients' perceived health state.
Self-reported comorbidity was studied in 344 adult JIA patients who have been included in the biologic register JuMBO. The comorbidity prevalence among the patients was compared to an age- and sex-matched reference group from the population. The correlation of comorbidity with clinical and demographic parameters was analysed by linear or logistic regression models.
Sixty two percent of the JIA patients reported at least one comorbidity. Uveitis was the most common comorbid condition (17.7%), followed by allergic rhinitis (14.5%), migraine (8.7%), and atopic dermatitis (8.7%). The prevalence of cardiovascular disorders was 9.9%, which was not higher than that in the population. However, patients with a systemic onset of JIA (soJIA) had a substantially higher rate of cardiovascular diseases of 40.6% (p=0.033). Patients with soJIA also had the highest prevalence (80.0%) and the highest mean number (1.8) of comorbidities. Patients with at least one comorbid condition suffered more often from fatigue and pain, had a lower functional capacity (p<0.001, each), and a lower physical and mental health-related quality of life than those without comorbidities (p<0.001 and p=0.017, respectively). The presence of any comorbidity and the level of disease activity were independent predictors of a lower SF-36 score.
Our results indicate that comorbid conditions have a significant impact on the perceived health state in adult JIA. Among all JIA patients, those with systemic onset carry the highest risk for comorbidities, in particular for cardiovascular disorders.
本研究旨在评估成人 JIA 患者的合并症患病率,以及合并症对患者感知健康状况的影响。
对已纳入生物登记 JuMBO 的 344 名成人 JIA 患者进行了自我报告的合并症研究。将患者的合并症患病率与人群中年龄和性别匹配的参考组进行比较。通过线性或逻辑回归模型分析合并症与临床和人口统计学参数的相关性。
62%的 JIA 患者报告至少有一种合并症。葡萄膜炎是最常见的合并症(17.7%),其次是过敏性鼻炎(14.5%)、偏头痛(8.7%)和特应性皮炎(8.7%)。心血管疾病的患病率为 9.9%,并不高于人群中的患病率。然而,全身型幼年特发性关节炎(soJIA)患者的心血管疾病发生率显著更高,为 40.6%(p=0.033)。soJIA 患者还具有最高的合并症患病率(80.0%)和最高的平均合并症数量(1.8)。至少有一种合并症的患者经常感到疲劳和疼痛,功能能力较低(p<0.001,每次),身心健康相关生活质量也低于无合并症的患者(p<0.001 和 p=0.017,分别)。任何合并症的存在和疾病活动程度是 SF-36 评分较低的独立预测因素。
我们的研究结果表明,合并症对成人 JIA 的感知健康状况有重大影响。在所有 JIA 患者中,全身型患者发生合并症的风险最高,尤其是心血管疾病。