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类风湿性关节炎与阿尔茨海默病呈负相关:一项基于人群的病例对照研究。

Rheumatoid Arthritis Was Negatively Associated with Alzheimer's Disease: A Population-Based Case-Control Study.

作者信息

Kao Li-Ting, Kang Jiunn-Horng, Lin Herng-Ching, Huang Chung-Chien, Lee Hsin-Chien, Chung Shiu-Dong

机构信息

Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.

Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

PLoS One. 2016 Dec 20;11(12):e0168106. doi: 10.1371/journal.pone.0168106. eCollection 2016.

Abstract

Some of the prior literature investigated the potential association between rheumatoid arthritis (RA) and Alzheimer's disease (AD) because these two diseases may share similar inflammatory mechanisms. Nevertheless, to date, findings of the previous literature are still controversial, and some methodological limitations were observed in those studies. The aim of this case-control study was to investigate the relationship between prior RA and AD using a large population-based dataset. This study used the Taiwan Longitudinal Health Insurance Database 2005. We included 2271 patients with AD who had received prescriptions for acetylcholinesterase inhibitors (AChEIs) as cases and 6813 patients without AD as controls in this study. In addition, we performed a conditional logistic regression to examine the odds ratio (OR) and 95% confidence interval (CI) for prior RA between cases and controls. The study found that 330 (3.63%) of the total sampled patients had an RA diagnosis before the index date. Additionally, prior RA was found in 60 (2.64%) cases and in 270 (3.96%) controls. The conditional logistic regression analysis showed that the crude OR of prior RA for cases was 0.66 (95% confidence interval (CI): 0.490.87) compared to controls. After adjusting for patients' geographic location, urbanization level, and comorbidities, the adjusted OR of prior RA for patients with AD was 0.73 (95% CI: 0.550.98) compared to those without AD. We concluded that there was an inverse association between prior RA and AD even after adjusting for potential confounders.

摘要

一些先前的文献研究了类风湿性关节炎(RA)与阿尔茨海默病(AD)之间的潜在关联,因为这两种疾病可能具有相似的炎症机制。然而,迄今为止,先前文献的研究结果仍存在争议,并且在这些研究中观察到了一些方法学上的局限性。本病例对照研究的目的是使用基于人群的大型数据集来研究既往RA与AD之间的关系。本研究使用了2005年台湾纵向健康保险数据库。在本研究中,我们纳入了2271例接受过乙酰胆碱酯酶抑制剂(AChEIs)处方的AD患者作为病例组,以及6813例无AD的患者作为对照组。此外,我们进行了条件逻辑回归分析,以检验病例组和对照组中既往RA的比值比(OR)和95%置信区间(CI)。研究发现,在所有抽样患者中,有330例(3.63%)在索引日期之前被诊断为RA。此外,在60例(2.64%)病例组和270例(3.96%)对照组中发现有既往RA。条件逻辑回归分析显示,与对照组相比,病例组既往RA的粗OR为0.66(95%置信区间(CI):0.490.87)。在调整患者的地理位置、城市化水平和合并症后,与无AD的患者相比,AD患者既往RA的调整后OR为0.73(95%CI:0.550.98)。我们得出结论,即使在调整潜在混杂因素后,既往RA与AD之间仍存在负相关。

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