a Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine , Taipei Medical University , Taipei , Taiwan.
b Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine , Taipei Medical University Hospital , Taipei , Taiwan.
Ann Med. 2018 Feb;50(1):83-90. doi: 10.1080/07853890.2017.1412088. Epub 2017 Dec 20.
In autoimmune rheumatic diseases (ARDs), the levels of inflammatory mediators are increased and microglia may be activated, resulting in an inflammatory state and the degeneration of dopaminergic neurons. We investigated the association between ARDs and Parkinson disease (PD).
We identified ARD patients through the Taiwan National Health Insurance Research Database from 2001 to 2012. From the general population, we randomly selected a comparison cohort that was frequency-matched by age (in 5-year increments), sex and index year. We analysed the risk of PD, stratified by sex, age and comorbidities, by using a Cox regression model.
The risk of PD was 1.37 times greater in ARD patients than in controls after adjustment for age, sex, and comorbidities. ARD subgroups, such as the rheumatoid arthritis and Sjogren syndrome (SS) cohorts, were associated with a significantly higher risk of PD (adjusted hazard ratio [HR], 1.14; 95% confidence interval [CI], 1.03-1.2 and adjusted HR, 1.56; 95% CI, 1.35-1.79, respectively). Furthermore, primary and secondary SS patients had significantly higher risks of PD (adjusted HR, 1.58; 95% CI, 1.32-1.88 and adjusted HR, 1.53, 95% CI, 1.23-1.90, respectively).
The risk of PD was significantly higher in the ARD patients. Prospective studies are needed to confirm whether ARDs indeed increase the risk of PD.
在自身免疫性风湿病（ARDs）中，炎症介质水平升高，小胶质细胞可能被激活，导致炎症状态和多巴胺能神经元变性。我们研究了 ARD 与帕金森病（PD）之间的关联。
我们通过台湾全民健康保险研究数据库，从 2001 年至 2012 年确定了 ARD 患者。从一般人群中，我们按照年龄（每 5 年为一档）、性别和索引年份，随机选择一个频数匹配的对照组。我们使用 Cox 回归模型，按性别、年龄和合并症对 PD 的风险进行分层分析。
在调整年龄、性别和合并症后，ARD 患者患 PD 的风险是对照组的 1.37 倍。ARD 亚组，如类风湿关节炎和干燥综合征（SS）队列，与 PD 的风险显著增加相关（调整后的危险比[HR]，1.14；95%置信区间[CI]，1.03-1.2 和调整后的 HR，1.56；95%CI，1.35-1.79）。此外，原发性和继发性 SS 患者患 PD 的风险显著增加（调整后的 HR，1.58；95%CI，1.32-1.88 和调整后的 HR，1.53，95%CI，1.23-1.90）。
ARD 患者患 PD 的风险显著增加。需要前瞻性研究来证实 ARD 是否确实增加 PD 的风险。
