Tseng Chia-Chun, Chang Shun-Jen, Tsai Wen-Chan, Ou Tsan-Teng, Wu Cheng-Chin, Sung Wan-Yu, Hsieh Ming-Chia, Yen Jeng-Hsien
aDepartment of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital bDepartment of Kinesiology, Health and Leisure Studies, National University of Kaohsiung cDivision of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital dGraduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung eDivision of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua fGraduate Institute of Integrated Medicine, China Medical University, Taichung gInstitute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.
Medicine (Baltimore). 2016 Jun;95(26):e3999. doi: 10.1097/MD.0000000000003999.
Past studies have shown inconsistent results on whether there is an association between multiple sclerosis (MS) and rheumatoid arthritis. To investigate the possible relationship between the 2 autoimmune diseases, we performed a nationwide cohort study utilizing the National Health Insurance Research Database and the Registry of Catastrophic Illness.A total of 1456 newly diagnosed patients with MS and 10,362 control patients were matched for age, sex, and initial diagnosis date. Patients with MS had a higher incidence of rheumatoid arthritis (age-adjusted standardized incidence ratio: 1.72; 95% confidence interval = 1.01-2.91). There was a positive correlation in being diagnosed with rheumatoid arthritis in patients previously diagnosed with MS when stratified by sex and age. The strength of this association remained statistically significant after adjusting for sex, age, and smoking history (hazard ratio: 1.78, 95% confidence interval = 1.24-2.56, P = 0.002).In conclusion, this study demonstrates that a diagnosis of MS increased the likelihood of a subsequent diagnosis of rheumatoid arthritis in patients, independent of sex, age, and smoking history.
过去的研究对于多发性硬化症（MS）与类风湿性关节炎之间是否存在关联给出了不一致的结果。为了探究这两种自身免疫性疾病之间可能存在的关系，我们利用国民健康保险研究数据库和重大伤病登记系统进行了一项全国性队列研究。总共1456名新诊断出的MS患者与10362名对照患者在年龄、性别和初次诊断日期上进行了匹配。MS患者患类风湿性关节炎的发生率更高（年龄调整标准化发病率比：1.72；95%置信区间=1.01 - 2.91）。在按性别和年龄分层时，先前被诊断为MS的患者被诊断为类风湿性关节炎存在正相关。在对性别、年龄和吸烟史进行调整后，这种关联的强度在统计学上仍然显著（风险比：1.78，95%置信区间=1.24 - 2.56，P = 0.002）。总之，本研究表明，MS诊断增加了患者随后被诊断为类风湿性关节炎的可能性，且不受性别、年龄和吸烟史的影响。
