Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Psychiatry Res. 2019 Dec;282:112484. doi: 10.1016/j.psychres.2019.112484. Epub 2019 Jul 20.
The current study was conducted with the aim to investigate the relationship between rheumatoid arthritis (RA) and bipolar disorder (BD). Potentially eligible studies were identified from Medline and EMBASE databases from inception to May 2019. Eligible cohort studies must include patients with RA and comparators without RA, follow them for incident BD and report the relative risk, hazard risk ratio or standardized incidence ratio and associated 95% confidence intervals (CI) comparing the incidence of BD between the two groups. Eligible case-control studies must include cases with BD and controls without BD, explore prior history of RA and report the odds ratio and associated 95% CI for this association. Point estimates with standard errors were extracted from individual study and were combined together using random-effect model, generic inverse variance method. A total of six studies fulfilled the inclusion criteria and were included into the meta-analysis. The risk of developing BD was significantly higher among patients with RA than individuals without RA with the pooled relative risk of 2.06 (95% CI, 1.34-3.17; I 86%). Chronic inflammation is a potential mechanism and could be a modifiable risk factor of BD. However, further studies are still required to confirm this.
本研究旨在探讨类风湿关节炎（RA）与双相障碍（BD）之间的关系。从 Medline 和 EMBASE 数据库中检索从成立到 2019 年 5 月的潜在合格研究。合格的队列研究必须包括 RA 患者和无 RA 的对照组，随访其发生 BD 的情况，并报告相对风险、风险比或标准化发病率比及其 95%置信区间（CI），比较两组之间 BD 的发病率。合格的病例对照研究必须包括 BD 病例和无 BD 的对照组，探讨 RA 的既往史，并报告这种关联的比值比及其 95%CI。从个体研究中提取点估计值及其标准误差，并使用随机效应模型、通用倒数方差法进行组合。共有六项研究符合纳入标准并纳入荟萃分析。与无 RA 个体相比，RA 患者发生 BD 的风险明显更高，合并相对风险为 2.06（95%CI，1.34-3.17；I 86%）。慢性炎症是一个潜在的机制，可能是 BD 的可修饰风险因素。然而，仍需要进一步的研究来证实这一点。
