Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Research Promotion Unit, Translation Research Center, Ehime University Hospital, Ehime, Japan.
Rheumatol Int. 2021 Sep;41(9):1633-1639. doi: 10.1007/s00296-021-04889-1. Epub 2021 Jun 6.
This study used data from a large-scale multicenter medical information database in Japan to estimate the incidence rate of herpes zoster (HZ) and to examine the relationship between hypertension, dyslipidemia, and diabetes mellitus (DM), and the risk of HZ among patients with rheumatoid arthritis (RA). The research dataset consisted of 221,196 records of potential target patients with RA extracted between April 1, 2008 and August 31, 2017 from the Medical Data Vision database. To assess the association between hypertension, dyslipidemia, and DM and the risk of HZ, a case-control study was set up. Records of 101,498 study subjects met the inclusion criteria. During the observation period, 2566 patients developed HZ and the overall incidence rate was 5.2 (95% confidence interval: 5.0-5.4 per 1000 patient-years). Hypertension, dyslipidemia, and DM were significantly associated with an increased risk of HZ after adjustment for sex, age, hospital size, and use of anti-rheumatic drugs. When mutual adjustment was made for hypertension, dyslipidemia, and DM, the positive associations between hypertension and dyslipidemia and the risk of HZ remained significant; however, the positive association with DM completely disappeared. RA patients with hypertension or dyslipidemia may be at higher risk of HZ.
本研究利用来自日本大规模多中心医学信息数据库的数据,估算了带状疱疹(HZ)的发病率,并探讨了高血压、血脂异常和糖尿病(DM)与类风湿关节炎(RA)患者发生 HZ 的风险之间的关系。研究数据集由从 Medical Data Vision 数据库中提取的 2008 年 4 月 1 日至 2017 年 8 月 31 日之间的 221196 例潜在目标 RA 患者记录组成。为评估高血压、血脂异常和 DM 与 HZ 风险之间的关联,进行了病例对照研究。符合纳入标准的记录有 101498 例研究对象。在观察期间,有 2566 例患者发生 HZ,总发病率为 5.2(95%置信区间:5.0-5.4/1000 患者-年)。在校正了性别、年龄、医院规模和抗风湿药物使用情况后,高血压、血脂异常和 DM 与 HZ 风险增加显著相关。当对高血压、血脂异常和 DM 进行相互调整时,高血压与血脂异常和 HZ 风险之间的正相关仍然显著;然而,与 DM 的正相关完全消失。患有高血压或血脂异常的 RA 患者可能有更高的 HZ 风险。