From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung 404, Taiwan, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan, Department of Public Health, China Medical University, Taichung 404, Taiwan, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan, Division of Nephrology, Department of Pediatrics, China Medical University Hospital and China Medical University, Taichung 404, Taiwan and Institute of Biostatistics, China Medical University, Taichung 404, TaiwanFrom the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung 404, Taiwan, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan, Department of Public Health, China Medical University, Taichung 404, Taiwan, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan, Division of Nephrology, Department of Pediatrics, China Medical University Hospital and China Medical University, Taichung 404, Taiwan and Institute of Biostatistics, China Medical University, Taichung 404, Taiwan.
From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital and China Medical University, Taichung 404, Taiwan, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan, Department of Public Health, China Medical University, Taichung 404, Taiwan, Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan, Division of Nephrology, Department of Pediatrics, China Medical University Hospital and China Medical University, Taichung 404, Taiwan and Institute of Biostatistics, China Medical University, Taichung 404, Taiwan.
QJM. 2014 Jun;107(6):435-42. doi: 10.1093/qjmed/hcu008. Epub 2014 Jan 20.
Several studies discussed the relations between asthma and rheumatoid arthritis (RA) but the results were controversial. These studies were either questionnaire based or with small study populations. We aimed to examine the risk of asthma among RA patients in a nationwide population.
We conducted a cohort study using data from the National Health Insurance system of Taiwan. The RA cohort included 27 602 patients who were newly diagnosed and recruited between 1998 and 2008. Each patient was randomly frequency-matched with three people without RA on age group, sex and the year of index date from the general population. The occurrence of asthma was followed up until the end of 2010. The relative risks of asthma were estimated using Cox proportional hazard models after adjusting for age and comorbidities.
The overall incidence rate of asthma was 2.07-fold greater in the RA cohort than in the non-RA cohort (4.56 vs. 2.22 per 1000 person-years, 95% CI = 1.99-2.15). Stratified analyses by gender, age group and comorbidity revealed that the risk of asthma associated with RA was higher in females (adjusted hazard ratio (HR) = 2.18, 95% CI = 1.97-2.41), individuals younger than 40 years old (adjusted HR = 3.26, 95% CI = 2.09-5.11) and without comorbidity (adjusted HR = 2.17, 95% CI = 1.97-2.39).
Patients with RA had a significantly higher risk of developing asthma than healthy people in all sex and age subgroups. Stratified analyses indicated that there was a higher risk in women with RA than in men with RA when compared to their counterpart. Similarly, the HR of asthma associated with RA was higher in younger subjects, although the incidence rate increased with age.
几项研究讨论了哮喘和类风湿关节炎（RA）之间的关系，但结果存在争议。这些研究要么基于问卷，要么研究人群规模较小。我们旨在在全国人群中研究 RA 患者患哮喘的风险。
我们使用来自台湾全民健康保险系统的数据进行了一项队列研究。RA 队列包括 27602 名在 1998 年至 2008 年间新诊断和招募的患者。每位患者按年龄组、性别和索引日期的年份与普通人群中的三人进行随机频数匹配。对哮喘的发生情况进行随访，直至 2010 年底。使用 Cox 比例风险模型在调整年龄和合并症后估计哮喘的相对风险。
RA 队列的哮喘总体发生率比非 RA 队列高 2.07 倍（4.56 比 2.22 每 1000 人年，95%CI=1.99-2.15）。按性别、年龄组和合并症分层分析显示，RA 相关哮喘的风险在女性中更高（调整后的危险比（HR）=2.18，95%CI=1.97-2.41），年龄小于 40 岁的个体（调整后的 HR=3.26，95%CI=2.09-5.11）和无合并症（调整后的 HR=2.17，95%CI=1.97-2.39）。
RA 患者发生哮喘的风险明显高于所有性别和年龄亚组的健康人群。分层分析表明，与同龄男性相比，女性 RA 患者的风险更高。同样，与 RA 相关的哮喘的 HR 在年轻患者中更高，尽管发病率随年龄增长而增加。
