Joint Rheumatology Program, Medical School, National and Kapodistrian University of Athens, Athens.
Medical School, University of Thessaly, Larissa.
Rheumatology (Oxford). 2021 Jan 5;60(1):170-178. doi: 10.1093/rheumatology/keaa321.
Evidence on comorbidity prevalence in antiphospholipid syndrome (APS) and its difference from high comorbidity burden rheumatic diseases is limited. Herein, we compare multiple comorbidities between APS and RA.
A total of 326 patients from the Greek APS registry [237 women, mean age 48.7 (13.4) years, 161 primary APS (PAPS), 165 SLE-APS] were age/sex matched (1:2 ratio) with 652 patients from a Greek multicentre RA cohort of 3115 patients. Prevalence of cardiovascular (CV) risk factors, stroke, coronary artery disease (CAD), osteoporosis, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), depression and neoplasms were compared between APS and RA patients using multivariate regression analysis.
Ηyperlipidemia and obesity (ΒΜΙ ≥ 30 kg/m2) were comparable while hypertension, smoking, stroke and CAD were more prevalent in APS compared with RA patients. Osteoporosis and depression were more frequent in APS, while DM, COPD and neoplasms did not differ between the two groups. Comparison of APS subgroups to 1:2 matched RA patients revealed that smoking and stroke were more prevalent in both PAPS and SLE-APS vs RA. Hypertension, CAD and osteoporosis were more frequent only in SLE-APS vs RA, whereas DM was less prevalent in PAPS vs RA. Hyperlipidaemia was independently associated with CV events (combined stroke and CAD) in PAPS and SLE-APS, while CS duration was associated with osteoporosis in SLE-APS.
Comorbidity burden in APS (PAPS and SLE-APS) is comparable or higher than that in RA, entailing a high level of diligence for CV risk prevention, awareness for depression and CS exposure minimization.
抗磷脂综合征（APS）的合并症患病率及其与高合并症负担的风湿性疾病的差异的证据有限。在此，我们比较了 APS 和类风湿关节炎（RA）之间的多种合并症。
共有 326 名来自希腊 APS 登记处的患者（237 名女性，平均年龄 48.7±13.4 岁，161 名原发性 APS（PAPS），165 名 SLE-APS），与来自希腊多中心 RA 队列的 3115 名患者中的 652 名患者进行年龄/性别匹配（1:2 比例）。使用多变量回归分析比较 APS 和 RA 患者之间心血管（CV）危险因素、中风、冠心病（CAD）、骨质疏松症、糖尿病（DM）、慢性阻塞性肺疾病（COPD）、抑郁症和肿瘤的患病率。
高脂血症和肥胖（BMI≥30kg/m2）相似，而高血压、吸烟、中风和 CAD 在 APS 患者中比 RA 患者更常见。骨质疏松症和抑郁症在 APS 中更为常见，而 DM、COPD 和肿瘤在两组之间无差异。与 1:2 匹配的 RA 患者比较 APS 亚组发现，无论是 PAPS 还是 SLE-APS，吸烟和中风的发生率均高于 RA。高血压、CAD 和骨质疏松症仅在 SLE-APS 中比 RA 更常见，而 PAPS 中 DM 的发生率低于 RA。高脂血症与 PAPS 和 SLE-APS 的 CV 事件（中风和 CAD 合并）独立相关，而 CS 持续时间与 SLE-APS 的骨质疏松症相关。
APS（PAPS 和 SLE-APS）的合并症负担与 RA 相当或更高，需要高度警惕预防 CV 风险、注意抑郁症和尽量减少 CS 暴露。
