University of Montreal Hospital Research Centre, Montreal, QC, Canada.
Institut national de santé publique du Québec, Montreal, QC, Canada.
Int J Epidemiol. 2018 Feb 1;47(1):280-288. doi: 10.1093/ije/dyx181.
We sought to determine if immune disorders early in life were associated with the later risk of Guillain-Barré syndrome, a neurological disorder thought to be infection-related.
We conducted a longitudinal cohort study with 16 108 819 person-years of follow-up for a population of 1 108 541 parous women in Quebec, Canada (1989-2014). The outcome was Guillain-Barré syndrome. We identified women with potential risk factors for future Guillain-Barré syndrome, including immune-mediated and rheumatological diseases, cancer, transfusion, surgical procedures and pregnancy-specific disorders. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association of risk factors with later onset of Guillain-Barré syndrome, adjusted for personal characteristics of women.
The overall incidence of Guillain-Barré syndrome was 1.42 per 100 000 person-years. Incidence was higher for women with immune-mediated (8.79 per 100 000 person-years) and rheumatological disorders (9.84 per 100 000 person-years), transfusion (4.41 per 100 000 person-years), and preeclampsia (2.62 per 100 000 person-years). Immune-mediated disorders were associated with six times the risk of Guillain-Barré syndrome (HR 6.57, 95% CI 3.58 to 12.04), rheumatological disorders with seven times the risk (HR 7.23, 95% CI 3.21 to 16.28), transfusion three times the risk (HR 3.58, 95% CI 1.83 to 6.98) and preeclampsia two times the risk (HR 2.01, 95% CI 1.29 to 3.12). Women with other potential risk factors did not have an increased risk of Guillain-Barré syndrome.
Immune-related conditions that occur early in life are associated with an increased risk of Guillain-Barré syndrome. The pathophysiology of Guillain-Barré syndrome may extend beyond infectious triggers.
我们试图确定生命早期的免疫紊乱是否与吉兰-巴雷综合征（一种被认为与感染有关的神经疾病）的后期风险相关。
我们进行了一项纵向队列研究，对加拿大魁北克省 1108541 名经产妇女（1989-2014 年）的 16108819 人年进行随访。结局是吉兰-巴雷综合征。我们确定了具有未来吉兰-巴雷综合征潜在风险因素的妇女，包括免疫介导和风湿性疾病、癌症、输血、手术和妊娠特异性疾病。我们估计了风险因素与吉兰-巴雷综合征后期发病的关联的风险比（HR）和 95%置信区间（CI），并对妇女的个人特征进行了调整。
吉兰-巴雷综合征的总体发病率为 1.42/10 万人年。免疫介导（8.79/10 万人年）和风湿性疾病（9.84/10 万人年）、输血（4.41/10 万人年）和子痫前期（2.62/10 万人年）的发病率较高。免疫介导的疾病与吉兰-巴雷综合征的风险增加六倍相关（HR 6.57，95%CI 3.58-12.04），风湿性疾病与七倍相关（HR 7.23，95%CI 3.21-16.28），输血与三倍相关（HR 3.58，95%CI 1.83-6.98），子痫前期与两倍相关（HR 2.01，95%CI 1.29-3.12）。具有其他潜在风险因素的妇女没有增加患吉兰-巴雷综合征的风险。
生命早期发生的与免疫相关的疾病与吉兰-巴雷综合征的风险增加相关。吉兰-巴雷综合征的病理生理学可能超出感染触发因素。
