Ahn Joong Kyong, Hwang Jiwon, Chang Yoosoo, Ryu Seungho
Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Rheumatology, Department of Internal Medicine, National Police Hospital, Seoul, South Korea.
Rheumatol Int. 2017 Jul;37(7):1135-1143. doi: 10.1007/s00296-017-3738-x. Epub 2017 May 17.
The aim of this study was to determine whether rheumatoid factor (RF) is associated with mortality from all-cause, cardiovascular disease (CVD), and cancer in the healthy adults. We recruited South Korean health check-up examinees without rheumatoid arthritis (RA). A cohort study was performed in 295,837 participants presumably free of osteoarthritis or RA, and who had undergone health screening between 2002 and 2012 and been followed up to determine the risk of all-cause, CVD, and cancer-specific mortality with respect to the presence or titer of RF. To determine whether the participants were deceased, we used National Death Index death certificates. The prevalence of RF positivity (≥20 IU/mL) was 4.4%. During 1,447,403 person-years of follow-up, 1402 participants died. Comparing subjects negative for RF with those positive for RF, the multivariable adjusted hazard ratio (HR; 95% CI) for all-cause and cancer mortality in subjects with RF-positivity was 1.50 (1.19-1.90) and 1.56 (1.12-2.16), respectively. Also, all-cause and cancer mortality risk was significantly greater in subjects with an RF titer greater than 100 IU/mL than in those with RF-negativity (HR = 2.68, 95% CI = 1.72-4.19; HR = 2.89, 95% CI = 1.58-5.28, respectively) after adjusting for multiple confounders. However, the HR for cardiovascular mortality was not higher in subjects with RF positivity than in those with RF negativity (HR = 0.98, 95% CI = 0.45-2.11). In Korean healthy adults, presumably without RA, RF was associated with a greater risk of all-cause and cancer mortality.
本研究的目的是确定类风湿因子（RF）是否与健康成年人的全因死亡率、心血管疾病（CVD）死亡率和癌症死亡率相关。我们招募了没有类风湿关节炎（RA）的韩国健康体检者。对295,837名可能没有骨关节炎或RA的参与者进行了队列研究，这些参与者在2002年至2012年期间接受了健康筛查，并进行了随访，以确定RF的存在或滴度与全因、CVD和癌症特异性死亡率风险之间的关系。为了确定参与者是否死亡，我们使用了国家死亡指数死亡证明。RF阳性（≥20 IU/mL）的患病率为4.4%。在1,447,403人年的随访期间，有1402名参与者死亡。将RF阴性的受试者与RF阳性的受试者进行比较，RF阳性受试者的全因和癌症死亡率的多变量调整风险比（HR；95%CI）分别为1.50（1.19 - 1.90）和1.56（1.12 - 2.16）。此外，在调整多个混杂因素后，RF滴度大于100 IU/mL的受试者的全因和癌症死亡风险显著高于RF阴性的受试者（HR分别为2.68，95%CI为1.72 - 4.19；HR为2.89，95%CI为1.58 - 5.28）。然而，RF阳性受试者的心血管死亡率HR并不高于RF阴性受试者（HR = 0.98，95%CI = 0.45 - 2.11）。在可能没有RA的韩国健康成年人中，RF与全因和癌症死亡风险增加相关。
