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与普通人群相比,类风湿关节炎或糖尿病患者的死亡率更高——挪威特隆赫姆健康研究。

Mortality is increased in patients with rheumatoid arthritis or diabetes compared to the general population - the Nord-Trøndelag Health Study.

机构信息

Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.

Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.

出版信息

Sci Rep. 2020 Feb 27;10(1):3593. doi: 10.1038/s41598-020-60621-2.

DOI:10.1038/s41598-020-60621-2
PMID:32108158
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7046618/
Abstract

Persons with rheumatoid arthritis (RA) or diabetes have increased risk of cardiovascular disease (CVD) and higher death rates compared to the general population. This study used data from the population-based Nord-Trøndelag Health Study (HUNT) and the Norwegian Cause of Death registry to compare all-cause mortality rates for RA or diabetes patients to the general population. We used Cox regression with age as time variable, adjusting for sex, smoking, body mass index, hypertension, total cholesterol, creatinine and previous CVD. To achieve proportional hazards, an interaction term with an age group variable (≤75 years or >75 years) was included for diabetes, smoking and previous CVD. Median follow-up was 18.1 years. Mortality occurred for 123 (32%) of the RA patients, 1,280 (44%) of the diabetes patients, 17 (52%) of the patients with both diseases and 11,641 (18%) of the controls. Both diseases were associated with statistically significantly increased mortality rates. The hazard ratio (HR) for RA was 1.24 (95% CI: 1.03-1.44). The HR of diabetes was 1.82 (1.60-2.04) for individuals ≤75 years old and 1.49 (1.39-1.59) for individuals >75 years. Diabetes had a significantly higher HR for death than RA for participants ≤75 years, but not significantly different for participants >75 years.

摘要

类风湿关节炎(RA)或糖尿病患者的心血管疾病(CVD)风险增加,死亡率高于普通人群。本研究使用基于人群的特隆赫姆健康研究(HUNT)和挪威死因登记处的数据,比较 RA 或糖尿病患者与普通人群的全因死亡率。我们使用 Cox 回归,以年龄为时间变量,调整性别、吸烟、体重指数、高血压、总胆固醇、肌酐和既往 CVD。为了实现比例风险,对于糖尿病、吸烟和既往 CVD,使用年龄组变量(≤75 岁或>75 岁)的交互项。中位随访时间为 18.1 年。123 例(32%)RA 患者、1280 例(44%)糖尿病患者、17 例(52%)同时患有两种疾病的患者和 11641 例(18%)对照组发生了死亡。两种疾病的死亡率均显著增加。RA 的危险比(HR)为 1.24(95%CI:1.03-1.44)。对于≤75 岁的个体,糖尿病的 HR 为 1.82(1.60-2.04),对于>75 岁的个体,HR 为 1.49(1.39-1.59)。对于≤75 岁的参与者,糖尿病的死亡风险 HR 明显高于 RA,但对于>75 岁的参与者,差异无统计学意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/d8d04103b577/41598_2020_60621_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/f05aa0bbc064/41598_2020_60621_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/081aa85887b8/41598_2020_60621_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/d8d04103b577/41598_2020_60621_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/f05aa0bbc064/41598_2020_60621_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/dfbde37c3e50/41598_2020_60621_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/ff3f23c1e3f0/41598_2020_60621_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/081aa85887b8/41598_2020_60621_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48b4/7046618/d8d04103b577/41598_2020_60621_Fig5_HTML.jpg

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