Department of Internal Medicine, Mayo Clinic. 200 1st St SW, Rochester, MN, USA 55902.
Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 10700; Division of Rheumatology, Mayo Clinic. 200 1st St SW, Rochester, MN, USA 55902.
Semin Arthritis Rheum. 2018 Dec;48(3):529-537. doi: 10.1016/j.semarthrit.2018.07.001. Epub 2018 Jul 11.
To investigate the association between smoking and giant cell arteritis (GCA).
A systematic review was performed and meta-analysis conducted on observational studies that reported absolute numbers and/or statistical comparisons with 95% confidence intervals comparing smoking history and presence of GCA, among patients with GCA and non-GCA controls. Studies were reviewed in accordance with PRISMA guidelines. Point estimates and standard errors were extracted from individual studies and were combined by the generic inverse variance method of DerSimonian and Laird. A random-effects meta-analysis was performed. Statistical heterogeneity was assessed using the Cochran's Q test which was complemented with the I statistic.
The initial search yielded 3312 articles. Of these, thirteen studies (8 prospective and, 5 retrospective case-control studies) with unique cohorts were identified and included in the primary analysis (ever vs. never smoking history). Patients in the GCA cohort were more likely to have a history of smoking with an odds ratio of 1.19 (95% CI, 1.01-1.39). Considerable heterogeneity was present (I= 85%). Five of these studies included information on current smoking status. One additional study, which only reported current smoking status, was also included. The GCA cohort showed an association with current smoking with an odds ratio of 1.18 (95% CI, 1.01-1.38).
Our study demonstrated a statistically significant increased risk of GCA among both current and ever smokers compared to non-smokers.
探讨吸烟与巨细胞动脉炎（GCA）之间的关联。
对报告吸烟史和 GCA 存在的绝对数量和/或 95%置信区间统计比较的观察性研究进行了系统评价和荟萃分析，这些研究比较了 GCA 患者和非 GCA 对照组患者。研究按照 PRISMA 指南进行了回顾。从各个研究中提取点估计值和标准误差，并通过 DerSimonian 和 Laird 的通用逆方差方法进行合并。进行了随机效应荟萃分析。使用 Cochran's Q 检验评估统计学异质性，并补充了 I 统计量。
最初的搜索产生了 3312 篇文章。其中，确定了 13 项具有独特队列的研究（8 项前瞻性和 5 项回顾性病例对照研究），并将其纳入主要分析（曾经吸烟史与从不吸烟史）。GCA 队列的患者更有可能有吸烟史，优势比为 1.19（95%CI，1.01-1.39）。存在相当大的异质性（I=85%）。其中 5 项研究包含了当前吸烟状况的信息。还纳入了另外一项仅报告当前吸烟状况的研究。GCA 队列显示与当前吸烟存在关联，优势比为 1.18（95%CI，1.01-1.38）。
与不吸烟者相比，我们的研究表明，当前吸烟者和曾经吸烟者患 GCA 的风险显著增加。
