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类风湿关节炎患者患骨关节炎风险增加:一项基于台湾全国人口的队列研究

Patients With Rheumatoid Arthritis Increased Risk of Developing Osteoarthritis: A Nationwide Population-Based Cohort Study in Taiwan.

作者信息

Lee Yung-Heng, Tsou Hsi-Kai, Kao Su-Ling, Gau Shuo-Yan, Bai Yi-Chiao, Lin Mei-Chen, Wei James Cheng-Chung

机构信息

Department of Health Services Administration, China Medical University, Taichung, Taiwan.

Department of Public Health, China Medical University, Taichung, Taiwan.

出版信息

Front Med (Lausanne). 2020 Sep 10;7:392. doi: 10.3389/fmed.2020.00392. eCollection 2020.

Abstract

To investigate the risk of developing OA in patients diagnosed with RA. In this study, we presented gender, age, urbanization, occupation and, comorbidities in a RA cohort and a non-RA cohort based on number and percentage. We investigated the OA risk in patients with RA. We conducted a retrospective cohort study with a 13-year longitudinal follow-up in Taiwan. Patients who received RA diagnoses between 2000 and 2012 were enrolled in the study cohort. The non-RA cohort were 1:1 propensity score matched with the RA cohort by age, gender, index year, urbanization, occupation, and comorbidities. The hazard ratios (HRs) and adjusted HRs (aHRs) were estimated after confounders were adjusted. Sensitivity analysis utilizing the Longitudinal Health Insurance Database (LHID) was conducted. We totally enrolled 63,626 cases in RA patients (study cohort) and matched controls. In the RA cohort, the crude HR for OA was 2.86 (95% confidence interval (CI), 2.63-3.11, < 0.001), and the aHR was 2.75 (95% CI, 2.52-2.99, < 0.001). (The study demonstrated that patients with RA had a higher risk for developing OA compared with the non-RA controls. Developing effective OA prevention strategies are necessary in patients with RA. This finding may be extended to evaluate the risk of OA among other kinds of inflammatory autoimmune diseases. Identifying the key pathogenesis mechanisms are necessary in the future study.

摘要

为了调查类风湿关节炎(RA)患者发生骨关节炎(OA)的风险。在本研究中,我们基于数量和百分比呈现了RA队列和非RA队列中的性别、年龄、城市化程度、职业及合并症情况。我们调查了RA患者发生OA的风险。我们在台湾进行了一项为期13年纵向随访的回顾性队列研究。2000年至2012年期间被诊断为RA的患者被纳入研究队列。非RA队列通过年龄、性别、索引年份、城市化程度、职业和合并症与RA队列进行1:1倾向评分匹配。在对混杂因素进行调整后估计风险比(HRs)和调整后的风险比(aHRs)。利用纵向健康保险数据库(LHID)进行了敏感性分析。我们总共纳入了63626例RA患者(研究队列)及匹配的对照。在RA队列中,OA的粗HR为2.86(95%置信区间(CI),2.63 - 3.11,<0.001),aHR为2.75(95%CI,2.52 - 2.99,<0.001)。该研究表明,与非RA对照相比,RA患者发生OA的风险更高。对RA患者制定有效的OA预防策略很有必要。这一发现可能扩展到评估其他类型炎症性自身免疫性疾病中OA的风险。未来的研究有必要确定关键的发病机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9bea/7511507/a916f5ec9766/fmed-07-00392-g0001.jpg

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