系统性红斑狼疮家族史与自身免疫性疾病风险：1977 - 2013年丹麦全国队列研究

Family history of systemic lupus erythematosus and risk of autoimmune disease: Nationwide Cohort Study in Denmark 1977-2013.

作者信息

Ulff-Møller Constance Jensina, Simonsen Jacob, Kyvik Kirsten Ohm, Jacobsen Søren, Frisch Morten

机构信息

Copenhagen Lupus and Vasculitis Clinic, Centre for Rheumatology and Spine Diseases, Rigshospitalet.

Department of Epidemiology Research, Statens Serum Institut, Copenhagen.

出版信息

Rheumatology (Oxford). 2017 Jun 1;56(6):957-964. doi: 10.1093/rheumatology/kex005.

DOI:10.1093/rheumatology/kex005

PMID:28339674

Abstract

OBJECTIVE

To provide population-based estimates of relative risk of SLE and other autoimmune diseases (ADs) in relatives of SLE patients.

METHODS

A cohort of 5 237 319 Danish residents identified through the Civil Registration System was coupled to their relatives through the parental link and followed for SLE and other ADs between 1977 and 2013 through linkage to the National Patient Register. Twin zygosity was established through the Danish Twin Registry. Hazard ratios (HRs) with 95% CIs were calculated using Cox proportional hazards regression analyses.

RESULTS

During 117.5 million person-years of follow-up, 3612 persons were hospitalized with SLE. HRs of SLE were high among first-degree (HR = 10.3; 95% CI: 8.25, 12.9; n = 80) and second- or third-degree relatives of SLE patients (HR = 3.60; 95% CI: 2.20, 5.90; n = 16). HRs for any AD were elevated in first-degree (HR = 1.51; 95% CI: 1.41, 1.62; n = 785) and second- or third-degree relatives of SLE patients (HR = 1.28; 95% CI: 1.18, 1.39; n = 582). Among individuals with SLE-affected first-degree relatives, the risk was significantly increased for RA (HR = 1.64; 95% CI: 1.35, 1.99; n = 103), IBD (HR = 1.21; 95% CI: 1.02, 1.43; n = 130) and type 1 diabetes mellitus (HR = 1.23; 95% CI: 1.01, 1.48; n = 106). Risk of other ADs was significantly increased both among SLE-affected first-degree (HR = 2.08; 95% CI: 1.88, 2.31; n = 371) and second- or third-degree relatives (HR = 1.38; 95% CI: 1.23, 1.54; n = 313).

CONCLUSION

Family history of SLE is associated with a clearly elevated risk of SLE and, to a much lesser degree, of RA and other ADs.

摘要

目的

提供基于人群的系统性红斑狼疮（SLE）患者亲属患SLE及其他自身免疫性疾病（ADs）的相对风险估计。

方法

通过民事登记系统识别出5237319名丹麦居民队列，并通过父母关系与他们的亲属建立联系，通过与国家患者登记处的数据链接，在1977年至2013年期间对SLE和其他ADs进行随访。通过丹麦双胞胎登记处确定双胞胎的合子性。使用Cox比例风险回归分析计算95%置信区间（CIs）的风险比（HRs）。

结果

在1.175亿人年的随访期间，3612人因SLE住院。SLE患者的一级亲属（HR = 10.3；95% CI：8.25，12.9；n = 80）和二级或三级亲属（HR = 3.60；95% CI：2.20，5.90；n = 16）患SLE的HRs较高。SLE患者的一级亲属（HR = 1.51；95% CI：1.41，1.62；n = 785）和二级或三级亲属（HR = 1.28；95% CI：1.18，1.39；n = 582）患任何ADs的HRs均升高。在有SLE患病一级亲属的个体中，类风湿关节炎（RA）（HR = 1.64；95% CI：1.35，1.99；n = 103）、炎症性肠病（IBD）（HR = 1.21；95% CI：1.02，1.43；n = 130）和1型糖尿病（HR = 1.23；95% CI：1.01，1.48；n = 106）的风险显著增加。在有SLE患病一级亲属（HR = 2.08；95% CI：1.88，2.31；n = 371）和二级或三级亲属（HR = 1.38；95% CI：1.23，1.54；n = 313）中，其他ADs的风险也显著增加。