Englund Martin, Merkel Peter A, Tomasson Gunnar, Segelmark Mårten, Mohammad Aladdin J
From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
J Rheumatol. 2016 Aug;43(8):1553-8. doi: 10.3899/jrheum.151151. Epub 2016 Jun 1.
To evaluate the consultation rates of selected comorbidities in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) compared with the general population in southern Sweden.
We used data from a population-based cohort of patients with AAV diagnosed between 1998 and 2010 in Southern Sweden (701,000 inhabitants). For each patient we identified 4 reference subjects randomly sampled from the general population and matched for year of birth, sex, area of residence, and index year. Using the population-based Skåne Healthcare Register, we identified relevant diagnostic codes, registered between 1998 and 2011, for selected comorbidities assigned after the date of diagnosis of AAV or the index date for the reference subjects. We calculated rate ratios for comorbidities (AAV:reference subjects).
There were 186 patients with AAV (95 women, mean age 64.5 yrs) and 744 reference persons included in the analysis. The highest rate ratios (AAV:reference) were obtained for osteoporosis (4.6, 95% CI 3.0-7.0), followed by venous thromboembolism (4.0, 95% CI 1.9-8.3), thyroid diseases (2.1, 95% CI 1.3-3.3), and diabetes mellitus (2.0, 95% CI 1.3-2.9). For ischemic heart disease, the rate ratio of 1.5 (95% CI 1.0-2.3) did not reach statistical significance. No statistically significant differences were found for cerebrovascular accidents.
AAV is associated with increased consultation rates of several comorbidities including osteoporosis and thromboembolic and endocrine disorders. Comorbid conditions should be taken into consideration when planning and providing care for patients with AAV.
评估瑞典南部抗中性粒细胞胞浆抗体相关性血管炎（AAV）患者中特定合并症的就诊率，并与普通人群进行比较。
我们使用了来自瑞典南部一个基于人群的队列数据，该队列中的AAV患者于1998年至2010年期间被诊断（当地居民70.1万）。对于每例患者，我们从普通人群中随机抽取4名对照对象，使其在出生年份、性别、居住地区和索引年份上相匹配。利用基于人群的斯科讷医疗保健登记册，我们确定了1998年至2011年期间在AAV诊断日期或对照对象索引日期之后记录的、与选定合并症相关的诊断代码。我们计算了合并症的发病率比（AAV患者：对照对象）。
共有186例AAV患者（95名女性，平均年龄64.5岁）和744名对照对象纳入分析。骨质疏松症的发病率比最高（AAV患者：对照对象，4.6，95%置信区间3.0 - 7.0），其次是静脉血栓栓塞（4.0，95%置信区间1.9 - 8.3）、甲状腺疾病（2.1，95%置信区间1.3 - 3.3）和糖尿病（2.0，95%置信区间1.3 - 2.9）。缺血性心脏病的发病率比为1.5（95%置信区间1.0 - 2.3），未达到统计学显著性。脑血管意外方面未发现统计学显著差异。
AAV与多种合并症的就诊率增加相关，包括骨质疏松症、血栓栓塞性疾病和内分泌紊乱。在为AAV患者制定和提供护理时，应考虑合并症情况
