Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Life Science, National Taiwan University, Taipei, Taiwan.
Eur J Orthod. 2022 Mar 30;44(2):226-231. doi: 10.1093/ejo/cjab050.
Juvenile idiopathic arthritis (JIA), an autoimmune disease, has been proposed to be comorbid with obstructive sleep apnoea (OSA). We aimed at testing the hypothesis that patients with JIA may presented with high risk of OSA in a cohort study.
This is a cohort study including patients with JIA from 1999 to 2013 identified from a longitudinal health registry. A matched non-JIA control group was also included. The primary outcome variable was presence of OSA. A Cox proportional hazard model was developed to estimate the risk of OSA in patients with JIA. A cumulative probability model was adopted to assess the time-dependent effect of JIA on OSA development, implying a causal link of the association.
A total of 2791 patients with JIA were included, and 11 164 individuals without JIA were selected as matched controls. A total of 95 included subjects had OSA: 31 in the JIA group and 64 in the control group. Patients with JIA were more likely to have OSA compared with controls (adjusted hazard ratio, aHR = 1.922, 95% confidence interval [CI] = 1.244-2.970). The incidence of developing OSA was particularly high among patients with JIA-associated deformity that presented at age 18-30 years (aHR = 1.993, 95% CI = 1.277-3.113) and males (aHR = 1.786, 95% CI = 1.097-2.906). The risk of developing OSA increased over 60 months (aHR = 2.523, 95% CI = 1.322-4.815) of follow-up after the JIA diagnosis.
Patients with JIA have a significantly increased risk of developing OSA compared with matched individuals without JIA.
幼年特发性关节炎（JIA）是一种自身免疫性疾病，据报道其与阻塞性睡眠呼吸暂停（OSA）存在共病关系。本研究旨在通过队列研究验证 JIA 患者存在 OSA 高风险的假说。
本队列研究纳入了 1999 年至 2013 年间来自纵向健康登记系统的 JIA 患者，并纳入了匹配的非 JIA 对照组。主要结局变量为 OSA 的存在。采用 Cox 比例风险模型来估计 JIA 患者发生 OSA 的风险。采用累积概率模型来评估 JIA 对 OSA 发展的时变效应，以暗示两者关联的因果关系。
共纳入 2791 例 JIA 患者，选择 11164 例无 JIA 的个体作为匹配对照。共纳入 95 例 OSA 患者：JIA 组 31 例，对照组 64 例。与对照组相比，JIA 患者更有可能发生 OSA（调整后的危险比，aHR=1.922，95%置信区间[CI]为 1.244-2.970）。18-30 岁时出现 JIA 相关畸形的 JIA 患者（aHR=1.993，95%CI=1.277-3.113）和男性（aHR=1.786，95%CI=1.097-2.906）发生 OSA 的风险尤其高。在 JIA 诊断后 60 个月的随访期间，发生 OSA 的风险增加（aHR=2.523，95%CI=1.322-4.815）。
与匹配的无 JIA 个体相比，JIA 患者发生 OSA 的风险显著增加。
