Cozier Yvette C, Coogan Patricia F, Govender Praveen, Berman Jeffrey S, Palmer Julie R, Rosenberg Lynn
Slone Epidemiology Center, Boston University; and Pulmonary Center Boston, MA.
Slone Epidemiology Center, Boston University; and Pulmonary Center Boston, MA.
Chest. 2015 Apr;147(4):1086-1093. doi: 10.1378/chest.14-1099.
Sarcoidosis, a systemic disorder characterized by chronic granulomatous inflammation, occurs more frequently among US black women, as do overweight and obesity. Little is known about the relation of overweight and obesity, which induce chronic inflammation, to incidence of sarcoidosis.
We assessed the relation of obesity and weight gain to the incidence of sarcoidosis in the Black Women's Health Study, a follow-up study of 59,000 US black women aged 21 to 69 years at baseline in 1995. Information on weight at age 18 years, height, current weight, incident sarcoidosis, and covariates was collected at baseline and on biennial follow-up questionnaires. Cox regression models adjusted for age, education, geographic region, smoking, alcohol consumption, and physical activity were used to estimate incidence rate ratios (IRRs) and 95% CIs.
From 1995 through 2011, 454 incident cases of sarcoidosis occurred during 707,557 person-years of follow-up. The incidence of sarcoidosis increased with increasing BMI and weight gain. The IRR was 1.40 (95% CI, 0.88-2.25) for BMI ≥ 30 kg/m2 at age 18 years relative to 20 to 24 kg/m2 (P trend = .18), 1.42 (95% CI, 1.07-1.89) for BMI ≥ 35 kg/m2 at baseline relative to 20 to 24 kg/m2 (P trend = .01), and 1.47 (95% CI, 1.10-1.97) for a weight gain between age 18 years and baseline of ≥ 30 kg relative to 0 to 9 kg (P trend = .16). In stratified analyses, there were significant trends of sarcoidosis incidence with increasing BMI and weight gain in women aged ≥ 45 years and ever smokers.
The present study provides evidence that weight gain and obesity during adulthood are associated with increased sarcoidosis incidence.
结节病是一种以慢性肉芽肿性炎症为特征的全身性疾病,在美国黑人女性中比超重和肥胖更为常见。关于引发慢性炎症的超重和肥胖与结节病发病率之间的关系,人们知之甚少。
在黑人女性健康研究中,我们评估了肥胖和体重增加与结节病发病率之间的关系。该研究是一项对1995年基线时年龄在21至69岁的59000名美国黑人女性进行的随访研究。在基线时以及每两年一次的随访问卷中收集了18岁时的体重、身高、当前体重、新发结节病以及协变量等信息。使用针对年龄、教育程度、地理区域、吸烟、饮酒和体育活动进行调整的Cox回归模型来估计发病率比(IRR)和95%置信区间(CI)。
从1995年到2011年,在707557人年的随访期间发生了454例新发结节病病例。结节病的发病率随着体重指数(BMI)的增加和体重增加而升高。相对于BMI为20至24kg/m²,18岁时BMI≥30kg/m²的发病率比为1.40(95%CI,0.88 - 2.25)(P趋势 = 0.18);相对于BMI为20至24kg/m²,基线时BMI≥35kg/m²的发病率比为1.42(95%CI,1.07 - 1.89)(P趋势 = 0.01);相对于18岁至基线时体重增加0至9kg,体重增加≥30kg的发病率比为1.47(95%CI,1.10 - 1.97)(P趋势 = 0.16)。在分层分析中,45岁及以上女性和曾经吸烟者中,结节病发病率随着BMI增加和体重增加存在显著趋势。
本研究提供了证据表明成年期体重增加和肥胖与结节病发病率增加有关。