Mayo Clinic, Rochester, Minnesota.
Brigham and Women's Hospital, Boston, Massachusetts.
Arthritis Care Res (Hoboken). 2021 Feb;73(2):180-187. doi: 10.1002/acr.24115.
Since comorbidities such as autoimmune diseases may be associated with rheumatoid arthritis (RA) risk, we hypothesized that a family history of these other conditions might also predict RA. Therefore, we aimed to determine the association between family history of 79 comorbidities and RA.
This case-control study identified 821 cases of RA in the Mayo Clinic Biobank (positive predictive value 95%) and matched 3 controls to each case based on age, sex, recruitment year, and location. Patients self reported family history and characteristics (adjusted). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for RA risk according to the presence of family history for each comorbidity, adjusted for body mass index, race, and smoking.
Family history of several conditions was associated with developing RA, including rheumatic autoimmune diseases (OR 1.89 [95% CI 1.41-2.52]), pulmonary fibrosis (OR 2.12 [95% CI 1.16-3.80]), inflammatory bowel disease (OR 1.45 [95% CI 1.05-1.98]), hyper/hypothyroidism (OR 1.34 [95% CI 1.10-1.63]), and obstructive sleep apnea (OR 1.28 [95% CI 1.05-1.55]). Parkinson's disease and type 2 diabetes mellitus were associated with a statistically decreased risk of RA that did not reach the prespecified significance threshold of P < 0.01 (OR 0.70 [95% CI 0.49-0.98] and OR 0.81 [95% CI 0.67-0.97], respectively). Analyses among 143 cases of incident RA were similar and also suggested an association with a family history of autism (OR 10.5 [95% CI 2.51-71.3]).
Family history of several autoimmune and nonautoimmune comorbidities was associated with increased risk of RA, providing an opportunity to identify novel populations at risk for RA.
由于自身免疫性疾病等合并症可能与类风湿关节炎（RA）的风险相关，因此我们假设这些其他疾病的家族史也可能预测 RA。因此，我们旨在确定 79 种合并症的家族史与 RA 之间的关联。
这项病例对照研究在 Mayo 诊所生物库中确定了 821 例 RA 患者（阳性预测值为 95%），并根据年龄、性别、招募年份和位置，为每位患者匹配了 3 名对照。患者自我报告家族史和特征（经调整）。使用逻辑回归根据每种合并症的家族史，估算 RA 风险的比值比（OR）和 95%置信区间（95%CI），并根据体重指数、种族和吸烟情况进行调整。
家族史中有几种疾病与 RA 的发生相关，包括风湿性自身免疫性疾病（OR 1.89[95%CI 1.41-2.52]）、肺纤维化（OR 2.12[95%CI 1.16-3.80]）、炎症性肠病（OR 1.45[95%CI 1.05-1.98]）、甲状腺功能亢进/减退症（OR 1.34[95%CI 1.10-1.63]）和阻塞性睡眠呼吸暂停（OR 1.28[95%CI 1.05-1.55]）。帕金森病和 2 型糖尿病与 RA 的风险呈统计学上降低相关，但未达到预先指定的 P < 0.01 显著性阈值（OR 0.70[95%CI 0.49-0.98]和 OR 0.81[95%CI 0.67-0.97]）。对 143 例新发 RA 病例的分析也表明，家族史与自闭症（OR 10.5[95%CI 2.51-71.3]）有关。
多种自身免疫性和非自身免疫性合并症的家族史与 RA 风险增加相关，为确定新的 RA 高危人群提供了机会。
