早期关节炎和早期脊柱关节炎的心血管疾病和选定合并症的比较研究：来自 ESPOIR 和 DESIR 队列的结果。
Cardiovascular and selected comorbidities in early arthritis and early spondyloarthritis, a comparative study: results from the ESPOIR and DESIR cohorts.
机构信息
Department of Rheumatology , Leiden University Medical Centre , Leiden , The Netherlands ; Department of Internal Medicine and Rheumatology , Cantacuzino Clinical Hospital , Bucharest , Romania.
Department of Rheumatology , Paris Descartes University-Hôpital Cochin, Assistance Publique-hôpitaux de Paris-INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité , Paris , France.
出版信息
RMD Open. 2015 Sep 14;1(1):e000128. doi: 10.1136/rmdopen-2015-000128. eCollection 2015.
OBJECTIVES
To investigate the prevalence of comorbidities in early rheumatoid arthritis (ERA) and early axial spondyloarthritis (ESpA) versus the general population.
METHODS
Baseline data of 689 patients with ERA from the Etude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) cohort (age 48.2±12.1 years, symptoms duration 14.2±14.5 weeks) and 645 patients with ESpA from Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; age 32.8±8.4 years, axial symptoms duration 79.0±45.7 weeks) were analysed. Metabolic and cardiovascular diseases (CVD), infections and neoplasia were determined in each cohort. The prevalence (95% CI) of several comorbidities was compared with that in the French general population. For patients without CVD, the 10-year risk of developing CVD was calculated using the Framingham and SCORE equations. The heart age was calculated using the 2008 Framingham points system.
RESULTS
42% of patients with ERA and 20.3% of patients with ESpA had at least 1 comorbidity; the most common were arterial hypertension (AHT) and dyslipidaemia. AHT prevalence (95% CI) in ERA (18.2% (15.5% to 21.3%)), but not in ESpA (5.08% (3.57% to 7.14%)), was significantly increased (p<0.05) compared with the general population (7.58%). Prevalence of tuberculosis history was higher in ERA (4.7% (3.3% to 6.6%)), and ESpA (0.99% (0.4% to 2.3%)) than in the general population (0.02%; both p<0.05). No differences were observed in malignancies, coronary heart disease or diabetes. In ERA, among patients without a history of CVD, an intermediate to high CVD risk was found. The heart age exceeded the real age by 4.1±9.6 years in ERA and by 2.1±7.0 years in ESpA (p<0.001).
CONCLUSIONS
We found an increased prevalence of AHT and tuberculosis history in ERA and ESpA, and an increased CVD risk. These results should prompt rheumatologists to check these comorbidities early in the disease.
目的
研究早期类风湿关节炎（ERA）和早期中轴型脊柱关节炎（ESpA）患者与普通人群相比共病的患病率。
方法
对来自最近未分化多关节炎研究（ESPOIR）队列的 689 例 ERA 患者（年龄 48.2±12.1 岁，症状持续时间 14.2±14.5 周）和来自最近未分化脊柱关节炎研究（DESIR）队列的 645 例 ESpA 患者（年龄 32.8±8.4 岁，中轴症状持续时间 79.0±45.7 周）的基线数据进行分析。在每个队列中确定代谢和心血管疾病（CVD）、感染和肿瘤。比较了几种共病的患病率与法国普通人群的患病率。对于无 CVD 的患者，使用Framingham 和 SCORE 方程计算发生 CVD 的 10 年风险。使用 2008 年 Framingham 积分系统计算心脏年龄。
结果
42%的 ERA 患者和 20.3%的 ESpA 患者至少有一种共病；最常见的是动脉高血压（AHT）和血脂异常。ERA 中 AHT 的患病率（95%CI）为 18.2%（15.5%至 21.3%），而 ESpA 中 AHT 的患病率（95%CI）为 5.08%（3.57%至 7.14%）显著高于普通人群（7.58%）（均 p<0.05）。ERA（4.7%（3.3%至 6.6%））和 ESpA（0.99%（0.4%至 2.3%））中结核病史的患病率均高于普通人群（0.02%）（均 p<0.05）。在恶性肿瘤、冠心病或糖尿病方面未观察到差异。在 ERA 中，在无 CVD 病史的患者中，发现 CVD 风险处于中高危水平。ERA 患者的心脏年龄比实际年龄大 4.1±9.6 岁，ESpA 患者的心脏年龄比实际年龄大 2.1±7.0 岁（均 p<0.001）。
结论
我们发现 ERA 和 ESpA 中 AHT 和结核病史的患病率增加，CVD 风险增加。这些结果应促使风湿病医生在疾病早期检查这些共病。
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