a Department of Epidemiology and Biostatistics, Faculty of Medicine , University of Iceland , Reykjavik , Iceland.
b Department of Rheumatology , University Hospital , Reykjavik , Iceland.
Scand J Rheumatol. 2019 May;48(3):213-217. doi: 10.1080/03009742.2018.1506821. Epub 2018 Nov 21.
To assess the strength of the effect of cardiovascular risk factors on the incidence of giant cell arteritis (GCA) in a general population context.
Data from the Reykjavik Study (RS), a population-based cohort study focusing on cardiovascular disease, were used. Everyone born in 1907-1935 living in Reykjavik, Iceland, or adjacent communities on 1 December 1967 were invited to participate. Subjects attended a study visit in 1967-1996 and information on cardiovascular risk factors [smoking habits, blood pressure, diabetes, body mass index (BMI), and serum cholesterol] was obtained. All temporal artery biopsies obtained from members of the RS cohort were re-examined by a single pathologist with expertise in vascular pathology. Effects of risk factors on GCA occurrence are expressed as incidence rate ratios (IRRs) with 95% confidence intervals (CIs).
Altogether, 19 241 subjects contributed a median of 23.1 (interquartile range 17.6-29.4) years after the age of 50 to this analysis. During 444 126 person-years of follow-up, 194 subjects developed GCA, corresponding to an incidence rate of 43.6 (95% CI 37.8-50.2) per 100 000 person-years. Being overweight or obese were inversely associated with GCA, especially in women [IRRs 0.70 (0.48-1.02) and 0.31 (0.14-0.71), respectively]. There was a weaker association between BMI and incident GCA in men. Smoking was inversely associated with GCA in men [IRR 0.47 (0.27-0.81)], but not in women.
The incidence of GCA in Iceland is very high. High BMI protects against the occurrence of GCA, and smoking may protect against GCA in men.
在一般人群背景下评估心血管危险因素对巨细胞动脉炎（GCA）发病的影响强度。
使用雷克雅未克研究（RS）的数据，这是一项针对心血管疾病的基于人群的队列研究。1967 年 12 月 1 日，邀请居住在冰岛雷克雅未克或附近社区的所有 1907-1935 年出生的人参加。研究对象于 1967-1996 年参加了研究访问，并获得了心血管危险因素（吸烟习惯、血压、糖尿病、体重指数（BMI）和血清胆固醇）的信息。对 RS 队列成员的所有颞动脉活检均由一位具有血管病理学专业知识的病理学家进行重新检查。危险因素对 GCA 发生的影响以发病率比（IRR）及其 95%置信区间（CI）表示。
共有 19 241 名受试者在 50 岁后平均贡献了 23.1 年（四分位距 17.6-29.4），用于这项分析。在 444 126 人年的随访期间，194 名受试者发生了 GCA，相应的发病率为 43.6（95%CI 37.8-50.2）/100000 人年。超重或肥胖与 GCA 呈负相关，尤其是在女性中[IRR 分别为 0.70（0.48-1.02）和 0.31（0.14-0.71）]。BMI 与男性 GCA 之间的关联较弱。吸烟与男性 GCA 呈负相关[IRR 0.47（0.27-0.81）]，但在女性中无此关联。
冰岛的 GCA 发病率非常高。高 BMI 可预防 GCA 的发生，而吸烟可能预防男性 GCA。
