Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.
Clinical Trial Unit, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Arthritis Res Ther. 2018 Oct 4;20(1):226. doi: 10.1186/s13075-018-1708-7.
Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is a group of life-threatening autoimmune diseases. The epidemiological data on AAV in China are limited. The aim of the present study is to investigate the frequency, geographical distribution, and ethnic distribution of AAV in hospitalized patients in China, and its association with environmental pollution.
We investigated the hospitalized patients in a national inpatient database covering 54.1% tertiary hospitals in China from 2010 to 2015. Diagnosis of AAV was extracted according to the definition of International Classification of Diseases (ICD)-10 codes and free text. Variables from the front page of inpatient records were collected and analyzed, including frequency, geographic distribution, demographic characteristics and seasonal variations of AAV. The association between various environmental pollutants and frequency of AAV was further analyzed.
Among 43.7 million inpatients included in the study period, 0.25‰ (10,943) were diagnosed as having AAV. The frequency of AAV was relatively stable during the study period (from 0.34‰ in 2010 to 0.27‰ in 2015). The proportion of AAV increased with latitude (0.44‰ in Northern China and 0.27‰ in Southern China in 2015). Hospitalizations were mostly observed in winter (30.2%). The Dong population, an ethnic minority of the Chinese population, had the highest frequency of patients with AAV (0.67‰). We also found a positive association between the exposure to carbon monoxide and the frequency of AAV (R = 0.172, p = 0.025). In Yunnan province, the frequency of AAV increased 1.37-fold after the Zhaotong earthquake, which took place in 2014.
Our present investigation of hospitalized patients provided epidemiological information on AAV in China for the first time. A spatial and ethnic clustering trend and an association between pollution and the frequency of AAV were observed.
抗中性粒细胞胞质抗体（ANCA）相关性血管炎（AAV）是一组危及生命的自身免疫性疾病。中国关于 AAV 的流行病学数据有限。本研究旨在调查中国住院患者中 AAV 的频率、地理分布和种族分布，及其与环境污染的关系。
我们调查了 2010 年至 2015 年期间覆盖中国 54.1%三级医院的全国住院患者数据库中的住院患者。根据国际疾病分类（ICD）-10 代码和自由文本提取 AAV 的诊断。收集和分析住院记录首页的变量，包括 AAV 的频率、地理分布、人口统计学特征和季节性变化。进一步分析了各种环境污染物与 AAV 频率之间的关系。
在所研究的 4370 万住院患者中，有 0.25‰（10943 人）被诊断为患有 AAV。在研究期间，AAV 的频率相对稳定（从 2010 年的 0.34‰降至 2015 年的 0.27‰）。AAV 的比例随纬度增加而增加（2015 年中国北方为 0.44‰，南方为 0.27‰）。住院治疗主要发生在冬季（30.2%）。汉族人口中的少数民族侗族人群 AAV 患者的频率最高（0.67‰）。我们还发现一氧化碳暴露与 AAV 的频率之间存在正相关（R=0.172，p=0.025）。2014 年昭通地震后，云南省 AAV 的频率增加了 1.37 倍。
我们对住院患者的本次调查首次提供了中国 AAV 的流行病学信息。观察到了空间和种族聚集趋势以及污染与 AAV 频率之间的关系。
