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日本老年类风湿关节炎患者常见共病(如高血压、血脂异常、糖尿病、心血管疾病、脑血管疾病和癌症)的 5 年发生率。

Five-year incidence of common comorbidities, such as hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease, cerebrovascular disease and cancer, in older Japanese patients with rheumatoid arthritis.

机构信息

Department of Orthopedic Surgery and Rheumatology, Kamagaya General Hospital, Chiba, Japan.

Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Geriatr Gerontol Int. 2019 Jul;19(7):577-581. doi: 10.1111/ggi.13664. Epub 2019 Apr 5.

Abstract

AIM

To estimate the 5-year incidence of common comorbidities, including lifestyle-associated diseases, in older Japanese patients with rheumatoid arthritis (RA).

METHODS

We enrolled 129 consecutive patients with RA aged ≥65 years in this study. We examined all patients for the presence of hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease, cerebrovascular disease and cancer at baseline (in 2013) and 5 years later (in 2018) using clinical records, self-reported questionnaires, interviews and medication records.

RESULTS

At baseline, hypertension was prevalent in 37.2% of the patients, dyslipidemia in 18.6%, diabetes mellitus in 9.3%, cardiovascular disease in 14.7%, cerebrovascular disease in 10.1% and cancer in 10.1%. Furthermore, the change of prevalence after 5 years from baseline of hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease, cerebrovascular disease and cancer was 4.6%, 3.9%, 0.8%, 4.7%, 2.3% and 1.5%, respectively. The factors associated at baseline and/or after 5 years of hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease and cancer included disease duration and body mass index, body mass index and anti-cyclic citrullinated peptide antibody, corticosteroid use, body mass index, and male and disease duration, respectively.

CONCLUSIONS

The Japanese population is aging and so is the population of patients with RA. In older patients with RA, hypertension and cardiovascular disease should be particularly considered. Therefore, although the therapeutic agents for RA have improved, a better understanding of the comorbidities in older patients with RA should impact the treatment of RA. Geriatr Gerontol Int 2019; 19: 577-581.

摘要

目的

评估日本老年类风湿关节炎(RA)患者常见合并症(包括与生活方式相关的疾病)的 5 年发病率。

方法

本研究纳入了 129 例年龄≥65 岁的连续 RA 患者。我们通过临床记录、自我报告问卷、访谈和用药记录,在基线(2013 年)和 5 年后(2018 年)检查所有患者是否存在高血压、血脂异常、糖尿病、心血管疾病、脑血管疾病和癌症。

结果

基线时,37.2%的患者患有高血压,18.6%的患者患有血脂异常,9.3%的患者患有糖尿病,14.7%的患者患有心血管疾病,10.1%的患者患有脑血管疾病,10.1%的患者患有癌症。此外,高血压、血脂异常、糖尿病、心血管疾病、脑血管疾病和癌症在 5 年后的患病率变化分别为 4.6%、3.9%、0.8%、4.7%、2.3%和 1.5%。基线和/或 5 年后高血压、血脂异常、糖尿病、心血管疾病和癌症的相关因素包括病程和体重指数、体重指数和抗环瓜氨酸肽抗体、皮质类固醇使用、体重指数、男性和病程。

结论

日本人口正在老龄化,RA 患者的人口也在老龄化。在老年 RA 患者中,应特别考虑高血压和心血管疾病。因此,尽管 RA 的治疗药物已有改善,但对老年 RA 患者合并症的更好理解应该会影响 RA 的治疗。老年医学与老年病学国际 2019; 19: 577-581.

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