Wu Meng-Che, Leong Pui-Ying, Chiou Jeng-Yuan, Chen Huang-Hsi, Huang Jing-Yang, Wei James Cheng-Chung
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Division of Gastroenterology, Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Front Med (Lausanne). 2020 Jan 29;6:330. doi: 10.3389/fmed.2019.00330. eCollection 2019.
(HP) infection is associated with systemic lupus erythematosus (SLE), but the related results have been controversial. Therefore, this study investigated the association between HP infection and SLE by using a nationwide longitudinal population-based cohort. We identified 41,651 patients with HP infection and 83,302 matched controls between 2000 and 2013 from the Longitudinal Health Insurance Research Database of the National Taiwan Insurance Research Database. Age, gender, comorbidities, and medical visits were matched at a 1:2 ratio by using propensity score analysis. The adjusted hazard ratio (aHR) of SLE was calculated by multiple Cox regression. Furthermore, sensitivity test and stratified analysis were performed. The SLE incidence rate was 1.17 [95% confidence interval (CI): 0.89-1.54] per 100,000 person-months in the HP cohort, and the hazard ratio was 1.63 (95% CI: 1.12-2.37) in comparison with the propensity score-matched control cohort. After multivariate adjustment, patients with HP infection had a significantly high overall aHR (1.58; 95% CI: 1.08-2.30) of SLE. Stratified analysis revealed the aHR of 8.23 (95% CI: 1.77-38.32) in patients <30 years old, and the for interaction between age and HP infection was 0.039. For age-sex subgroup analysis, the highest aHR was 12.74 (95% CI: 1.55-104.59) in young (aged <30 years) female patients with HP infection. HP infection is associated with a 1.63-fold increased SLE risk, particularly with female patients aged <30 years. Future research is required to elucidate the underlying mechanism of this association.
幽门螺杆菌（HP）感染与系统性红斑狼疮（SLE）相关，但相关结果一直存在争议。因此，本研究通过一项基于全国纵向人群的队列研究，调查了HP感染与SLE之间的关联。我们从台湾地区全民健康保险研究数据库的纵向健康保险研究数据库中，确定了2000年至2013年间41651例HP感染患者和83302例匹配对照。通过倾向得分分析，年龄、性别、合并症和就诊次数按1:2的比例进行匹配。采用多重Cox回归计算SLE的调整后风险比（aHR）。此外，还进行了敏感性检验和分层分析。HP队列中SLE发病率为每10万人月1.17[95%置信区间（CI）：0.89 - 1.54]，与倾向得分匹配的对照队列相比，风险比为1.63（95%CI：1.12 - 2.37）。多变量调整后，HP感染患者的SLE总体aHR显著升高（1.58；95%CI：1.08 - 2.30）。分层分析显示，<30岁患者的aHR为8.23（95%CI：1.77 - 38.32），年龄与HP感染之间的交互作用P值为0.039。对于年龄 - 性别亚组分析，HP感染的年轻（<30岁）女性患者中aHR最高，为12.74（95%CI：1.55 - 104.59）。HP感染与SLE风险增加1.63倍相关，尤其是<30岁的女性患者。需要进一步的研究来阐明这种关联的潜在机制。
