拉丁美洲脊柱关节炎患者合并症及合并症风险因素的流行情况：与普通人群的比较研究以及 ASAS-COMOSPA 研究的数据。
Prevalence of Comorbidities and Risk Factors for Comorbidities in Patients with Spondyloarthritis in Latin America: A Comparative Study with the General Population and Data from the ASAS-COMOSPA Study.
机构信息
From the Rheumatology Department, Leiden University Medical Center, Leiden, the Netherlands; School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar, Bogotá, Colombia; Amsterdam Rheumatology and Clinical Immunology Center, Amsterdam; Zuyderland Medical Center Heerlen, Heerlen, the Netherlands; Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico; School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo, Buenos Aires, Argentina; Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP; INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, Paris, France; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
W. Bautista-Molano, MD, Rheumatology Department, Leiden University Medical Center, and School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; R. Landewé, MD, PhD, Amsterdam Rheumatology and Clinical Immunology Center, and Zuyderland Medical Center Heerlen; R. Burgos-Vargas, MD, Servicio de Reumatología, Hospital General de México and Universidad Nacional Autónoma de México; J. Maldonado-Cocco, MD, School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo; A. Moltó, MD, PhD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; F. van den Bosch, MD, PhD, Department of Rheumatology, Ghent University Hospital; R. Valle-Oñate, MD, School of Medicine, Universidad Militar Nueva Granada and Rheumatology Department, Hospital Militar; M. Dougados, MD, Rheumatology B Department, Paris Descartes University, Cochin Hospital, AP-HP, and INSERM (U1153): Clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité; D. van der Heijde, MD, PhD, Rheumatology Department, Leiden University Medical Center.
出版信息
J Rheumatol. 2018 Feb;45(2):206-212. doi: 10.3899/jrheum.170520. Epub 2017 Dec 15.
OBJECTIVE
Increased risk of comorbidities has been reported in spondyloarthritis (SpA). The objective of this study was to determine the prevalence and risk of developing comorbidities in patients with SpA in 3 Latin American (LA) countries, and to compare that prevalence with the general population.
METHODS
Data were analyzed from 390 patients with SpA enrolled in the Assessment of SpondyloArthritis international Society of Comorbidities in SpA study from Argentina, Colombia, and Mexico. Age- and sex-standardized prevalence (95% CI) was estimated for arterial hypertension (AHT), tuberculosis (TB), and malignancies. Age- and sex-specific data from the general population were obtained from the Cardiovascular Risk Factor Multiple Evaluation in Latin America (CARMELA) study for AHT, the Global TB report, and the GLOBOCAN project for malignancies. Data analyzed for AHT were confined to Colombia and Mexico. The prevalence in patients with SpA was compared with the prevalence in the general population per age- and sex-specific stratum, resulting in standardized risk ratios (SRR).
RESULTS
In total, 64% of the patients with SpA were male, with a mean age of 45 years (SD 14.7). The most common comorbidities in the 3 LA countries were AHT (25.3%, 95% CI 21.2-30.0), hypercholesterolemia (21.5%, 95% CI 17.6-26.0), and osteoporosis (9.4%, 95% CI 6.8-12.9). AHT prevalence in Colombia and Mexico was 21.4% (95% CI 15.4-28.9) and was higher than the general population (12.5%, 95% CI 11.4-13.7), resulting in an SRR of 1.5. TB prevalence in the 3 LA countries was 3.3% (95% CI 1.8-5.7), which was significantly higher than in the general population (0.32%), leading to an SRR of 10.3. The prevalence of malignancies was not increased.
CONCLUSION
Patients with SpA in LA are at increased risk of AHT and TB in comparison to the general population. While this sample of patients may not be entirely representative of the patient population in each country, a systematic evaluation of these comorbidities in all patients with SpA still may help to monitor these conditions better.
目的
据报道，脊柱关节炎（SpA）患者合并症的风险增加。本研究的目的是确定 3 个拉丁美洲（LA）国家 SpA 患者合并症的患病率和发病风险，并将该患病率与普通人群进行比较。
方法
本研究对来自阿根廷、哥伦比亚和墨西哥的 390 名 SpA 患者进行了评估，这些患者均参与了 SpA 国际学会合并症研究。采用年龄和性别标准化患病率（95%CI）来估计高血压（AHT）、结核病（TB）和恶性肿瘤的患病情况。采用拉丁美洲心血管危险因素多重评估研究（CARMELA）获取 AHT 的年龄和性别特异性数据，采用全球 TB 报告获取 TB 数据，采用 GLOBOCAN 项目获取恶性肿瘤数据。仅对哥伦比亚和墨西哥的 AHT 数据进行分析。将 SpA 患者的患病率与每个年龄和性别特定分层的普通人群患病率进行比较，从而得出标准化风险比（SRR）。
结果
3 个 LA 国家的患者中，64%为男性，平均年龄为 45 岁（标准差 14.7）。最常见的合并症是 AHT（25.3%，95%CI 21.2-30.0）、高胆固醇血症（21.5%，95%CI 17.6-26.0）和骨质疏松症（9.4%，95%CI 6.8-12.9）。哥伦比亚和墨西哥的 AHT 患病率为 21.4%（95%CI 15.4-28.9），高于普通人群（12.5%，95%CI 11.4-13.7），SRR 为 1.5。3 个 LA 国家的 TB 患病率为 3.3%（95%CI 1.8-5.7），显著高于普通人群（0.32%），SRR 为 10.3。恶性肿瘤的患病率没有增加。
结论
与普通人群相比，LA 的 SpA 患者发生 AHT 和 TB 的风险增加。尽管该患者样本可能不完全代表每个国家的患者人群，但对所有 SpA 患者进行这些合并症的系统评估仍有助于更好地监测这些疾病。
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