Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam.
Division of Rheumatology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju.
Rheumatology (Oxford). 2019 Sep 1;58(9):1617-1622. doi: 10.1093/rheumatology/kez081.
We examined the association between socioeconomic status (SES) and comorbidity distribution among patients with RA.
Information on comprehensive health status of 1088 RA patients (weighted n = 612 303) was obtained from the 2007-2015 Korea National Health and Nutrition Examination Survey database. SES components were household equivalence income, education and area of residence. To minimize confounding by age, patients were stratified by median age (63 years). Age-adjusted odds ratio (OR) with 95% confidence interval (95% CI) was estimated, comparing weighted prevalence of individual comorbidities between low and high SES groups in each age stratum.
Among RA patients aged <63 years (mean 49 years, 70% female), we observed age-adjusted associations of depression (OR 2.13, 95% CI 1.01, 4.53), depressive mood (OR 2.68, 95% CI 1.54, 4.65), suicide ideation (OR 3.01, 95% CI 1.79, 5.07), diabetes (OR 3.09, 95%CI 1.31, 7.29), obesity (OR 2.04, 95% CI 1.30, 3.20), hypertriglyceridemia (OR 2.36, 95% CI 1.28, 4.34) and osteoarthritis (OR 2.12, 95% CI 1.13, 3.99) with low income, of suicide ideation with low education (OR 2.25, 95% CI 1.14, 4.44), but no association of any comorbidities with area of residence. Unhealthy behavior patterns were comparable between low- and high-income groups but patients with low income reported a numerically higher rate of failed access to necessary healthcare services. We did not find any association between SES and comorbidities among those aged ⩾63 years (mean 72 years, 83% female).
Among Korean RA patients aged <63 years, socioeconomic inequalities of multiple comorbidities in mental, cardiometabolic and musculoskeletal systems were found.
我们研究了社会经济地位（SES）与 RA 患者共病分布之间的关系。
2007-2015 年韩国国家健康和营养调查数据库获得了 1088 例 RA 患者（加权 n = 612303）的综合健康状况信息。SES 构成部分是家庭等效收入、教育程度和居住地区。为了最小化年龄混杂，根据中位年龄（63 岁）对患者进行分层。在每个年龄组中，比较低 SES 组和高 SES 组中个体共病的加权患病率，计算调整年龄的比值比（OR）及其 95%置信区间（95%CI）。
在年龄<63 岁（平均 49 岁，70%为女性）的 RA 患者中，我们观察到抑郁（OR 2.13，95%CI 1.01，4.53）、抑郁情绪（OR 2.68，95%CI 1.54，4.65）、自杀意念（OR 3.01，95%CI 1.79，5.07）、糖尿病（OR 3.09，95%CI 1.31，7.29）、肥胖（OR 2.04，95%CI 1.30，3.20）、高三酰甘油血症（OR 2.36，95%CI 1.28，4.34）和骨关节炎（OR 2.12，95%CI 1.13，3.99）与低收入相关，与低教育程度相关的自杀意念（OR 2.25，95%CI 1.14，4.44），但居住地区与任何共病均无关联。低收入组与高收入组的不健康行为模式相当，但低收入患者报告无法获得必要医疗保健服务的比例较高。我们未发现 SES 与 ⩾63 岁年龄组（平均 72 岁，83%为女性）共病之间的任何关联。
在韩国年龄<63 岁的 RA 患者中，发现了精神、心血管代谢和肌肉骨骼系统多种共病的社会经济不平等。
