Lai Ning-Sheng, Tsai Tzung-Yi, Koo Malcolm, Lu Ming-Chi
Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Allergy Asthma Proc. 2015 Sep-Oct;36(5):99-103. doi: 10.2500/aap.2015.36.3871.
Low-grade inflammation conditions, e.g., type 2 diabetes, have been shown to be associated with an increased risk of rheumatoid arthritis (RA). However, the association between other chronic inflammatory conditions, e.g., asthma, allergic rhinitis, and atopic dermatitis, is still unclear.
To investigate the risk of RA in patients with allergic diseases, including asthma, allergic rhinitis, and atopic dermatitis, by using a nationwide health claims database.
The Taiwan National Health Insurance Research Database was used to assemble a cohort of 170,570 patients ages 20 years old and older diagnosed with allergic diseases, including asthma, allergic rhinitis, or atopic dermatitis. A comparison cohort of 170,238 patients was constructed from the same data base, with frequency matching for sex, 10-year age group, and year of insurance enrollment. Cox proportional hazards regression analyses were conducted to assess the association between the allergic diseases and incident RA.
Asthma (adjusted hazard ratio [AHR] 1.67, [95% confidence interval {CI}], 1.32-2.62) and allergic rhinitis (AHR 1.62 [95% CI, 1.33-1.98]) were significantly associated with the incident RA. These associations remained significant even after excluding patients who had concurrent diagnoses of asthma and allergic rhinitis. Patients with more than one allergic disease had an increased risk of developing RA (AHR 1.98 [95% CI, 1.50-2.62]). Subgroup analysis further indicated that middle-aged and elderly female patients with more than one allergic disease exhibited a high risk of developing RA.
Significant associations between common allergic diseases and incident RA was found in this population-based cohort study. Our findings provided support to the hypothesis that allergic diseases and RA might share a similar underlying etiologic pathway related to chronic inflammatory responses.
低度炎症状态，如2型糖尿病，已被证明与类风湿关节炎（RA）风险增加有关。然而，其他慢性炎症性疾病，如哮喘、过敏性鼻炎和特应性皮炎之间的关联仍不明确。
通过使用全国性的健康保险索赔数据库，调查患有包括哮喘、过敏性鼻炎和特应性皮炎在内的过敏性疾病患者患RA的风险。
利用台湾国民健康保险研究数据库，纳入了170,570名年龄在20岁及以上、被诊断患有过敏性疾病（包括哮喘、过敏性鼻炎或特应性皮炎）的患者组成队列。从同一数据库中构建了一个由170,238名患者组成的对照队列，并按性别、10岁年龄组和参保年份进行频数匹配。进行Cox比例风险回归分析，以评估过敏性疾病与新发RA之间的关联。
哮喘（调整后风险比[AHR]为1.67，[95%置信区间{CI}]为1.32 - 2.62）和过敏性鼻炎（AHR为1.62 [95% CI为1.33 - 1.98]）与新发RA显著相关。即使排除同时诊断有哮喘和过敏性鼻炎的患者，这些关联仍然显著。患有不止一种过敏性疾病的患者患RA的风险增加（AHR为1.98 [95% CI为1.50 - 2.62]）。亚组分析进一步表明，患有不止一种过敏性疾病的中老年女性患者患RA的风险较高。
在这项基于人群的队列研究中，发现常见过敏性疾病与新发RA之间存在显著关联。我们的研究结果支持了以下假设：过敏性疾病和RA可能共享一条与慢性炎症反应相关的相似潜在病因途径。
