Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
Department of Rheumatology, Skåne University Hospital, Malmö and Lund, Sweden.
Rheumatology (Oxford). 2020 Nov 1;59(11):3229-3236. doi: 10.1093/rheumatology/keaa080.
To investigate metabolic features that may predispose to GCA in a nested case-control study.
Individuals who developed GCA after inclusion in a population-based health survey (the Malmö Preventive Medicine Project; N = 33 346) were identified and validated through a structured review of medical records. Four controls for every validated case were selected from the database.
A total of 76 cases with a confirmed incident diagnosis of GCA (61% female, 65% biopsy positive, mean age at diagnosis 70 years) were identified. The median time from screening to diagnosis was 20.7 years (range 3.0-32.1). Cases had significantly lower fasting blood glucose (FBG) at baseline screening compared with controls [mean 4.7 vs 5.1 mmol/l (S.d. overall 1.5), odds ratio (OR) 0.35 per mmol/l (95% CI 0.17, 0.71)] and the association remained significant when adjusted for smoking [OR 0.33 per mmol/l (95% CI 0.16, 0.68)]. Current smokers had a reduced risk of GCA [OR 0.35 (95% CI 0.18, 0.70)]. Both cholesterol [mean 5.6 vs 6.0 mmol/l (S.d. overall 1.0)] and triglyceride levels [median 1.0 vs 1.2 mmol/l (S.d. overall 0.8)] were lower among the cases at baseline screening, with significant negative associations with subsequent GCA in crude and smoking-adjusted models [OR 0.62 per mmol/l (95% CI 0.43, 0.90) for cholesterol; 0.46 per mmol/l (95% CI 0.27, 0.81) for triglycerides].
Development of GCA was associated with lower FBG and lower cholesterol and triglyceride levels at baseline, all adjusted for current smoking, suggesting that metabolic features predispose to GCA.
在一项巢式病例对照研究中，探讨可能导致巨细胞动脉炎（GCA）的代谢特征。
从基于人群的健康调查（马尔默预防医学项目；N=33346）中纳入的个体中确定并验证发生 GCA 的患者，并通过对病历进行结构化审查来验证。每例确诊的 GCA 患者选择 4 名对照。
共确定了 76 例经证实的 GCA 新发病例（61%为女性，65%经活检证实，诊断时的平均年龄为 70 岁）。从筛查到诊断的中位时间为 20.7 年（范围 3.0-32.1）。与对照组相比，病例组在基线筛查时的空腹血糖（FBG）显著较低[平均 4.7 与 5.1mmol/l（总体标准差为 1.5），每 mmol/l 的比值比（OR）为 0.35（95%CI 0.17，0.71）]，且在调整吸烟因素后，该关联仍然显著[每 mmol/l 的 OR 为 0.33（95%CI 0.16，0.68）]。当前吸烟者 GCA 风险降低[OR 为 0.35（95%CI 0.18，0.70）]。病例组在基线筛查时的胆固醇[平均 5.6 与 6.0mmol/l（总体标准差为 1.0）]和甘油三酯水平[中位数 1.0 与 1.2mmol/l（总体标准差为 0.8）]均较低，且在未经调整和调整吸烟因素的模型中，与随后发生的 GCA 均呈显著负相关[胆固醇每 mmol/l 的 OR 为 0.62（95%CI 0.43，0.90）；甘油三酯每 mmol/l 的 OR 为 0.46（95%CI 0.27，0.81）]。
GCA 的发生与基线时的 FBG 降低以及胆固醇和甘油三酯水平降低有关，所有这些均与当前吸烟情况有关，提示代谢特征可能导致 GCA 的发生。
