School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
School of Clinical Medline, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
Front Immunol. 2021 Oct 22;12:768741. doi: 10.3389/fimmu.2021.768741. eCollection 2021.
Previous literature on the association between infections and the risk of developing ankylosing spondylitis (AS) presented controversial results. This meta-analysis aimed to quantitatively investigate the effect of infections on the risk of AS.
We searched the PubMed, Embase, and Web of Science databases until March 26, 2021 for analytical epidemiological studies on the association between infections and the risk of AS. Fixed or random effect models were used to calculate total risk estimates based on study heterogeneity. Subgroup analysis, and sensitivity analysis were also performed. Publication bias was estimated using funnel plots and Begg's test.
Six case-control articles (n=1,296,239) and seven cohort articles (n=7,618,524) were incorporated into our meta-analysis. The pooled odds ratio (OR) from these case-control studies showed that infections were associated with an increased risk of AS (OR=1.46, 95% confidence interval [CI], 1.23-1.73), and the pooled relative risk (RR) from the cohort studies showed the same findings (RR=1.35, 95% CI, 1.12-1.63). Subgroup analysis showed that infections in participants with unadjusted comorbidities (OR=1.66, 95% CI, 1.35-2.03), other types of infection (OR=1.40, 95% CI, 1.15-1.70), and infection of the immune system (OR=1.46, 95% CI, 1.42-1.49) were associated with the risk of AS in case-control studies. In cohort studies, infections with adjusted comorbidities (RR=1.39, 95% CI, 1.15-1.68), viral infection (RR=1.43, 95% CI, 1.22-1.66), other types of infection (RR=1.44, 95% CI, 1.12-1.86), and other sites of infection (RR=1.36, 95% CI, 1.11-1.67) were associated with an increased risk of AS.
The findings of this meta-analysis confirm that infections significantly increase the risks of AS. This is helpful in providing an essential basis for the prevention of AS the avoidance of infections.
之前关于感染与强直性脊柱炎（AS）发病风险之间关联的文献结果存在争议。本荟萃分析旨在定量研究感染对 AS 发病风险的影响。
我们检索了 PubMed、Embase 和 Web of Science 数据库，截至 2021 年 3 月 26 日，以获取关于感染与 AS 发病风险之间关联的分析性流行病学研究。根据研究异质性，采用固定或随机效应模型计算总风险估计值。还进行了亚组分析和敏感性分析。使用漏斗图和 Begg 检验估计发表偏倚。
纳入了 6 项病例对照研究（n=1,296,239）和 7 项队列研究（n=7,618,524）。这些病例对照研究的汇总优势比（OR）表明，感染与 AS 发病风险增加相关（OR=1.46，95%置信区间[CI]，1.23-1.73），队列研究的汇总相对风险（RR）也显示了相同的结果（RR=1.35，95%CI，1.12-1.63）。亚组分析表明，参与者中有未经调整的合并症（OR=1.66，95%CI，1.35-2.03）、其他类型的感染（OR=1.40，95%CI，1.15-1.70）和免疫系统感染（OR=1.46，95%CI，1.42-1.49）与病例对照研究中的 AS 发病风险相关。在队列研究中，调整合并症的感染（RR=1.39，95%CI，1.15-1.68）、病毒感染（RR=1.43，95%CI，1.22-1.66）、其他类型的感染（RR=1.44，95%CI，1.12-1.86）和其他部位的感染（RR=1.36，95%CI，1.11-1.67）与 AS 发病风险增加相关。
本荟萃分析的结果证实，感染显著增加了 AS 的发病风险。这有助于为 AS 的预防提供重要依据，避免感染。
