Booth Michael J, Kobayashi Lindsay C, Janevic Mary R, Clauw Daniel, Piette John D
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48130, USA.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
BMC Rheumatol. 2021 Nov 12;5(1):48. doi: 10.1186/s41927-021-00219-x.
Immune-mediated inflammatory diseases (IMID) are characterized by systemic inflammation affecting the joints and bodily organs. Studies examining the association between individual IMIDs and the risk of Alzheimer's disease (AD) have yielded inconsistent findings. This study examines AD risk across a group of IMIDs in a large population-based sample of older adults.
Data on a national sample of US adults over age 50 was drawn from the Health and Retirement Study (HRS) and linked Medicare claims from 2006 to 2014. IMIDs include rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, and related conditions. We identified IMIDs from 2006 to 2009 Medicare claims using International Classification of Diseases (ICD9-CM) codes. The date of incident AD was derived from Chronic Conditions Warehouse (CCW) identifiers. We examined the risk of AD from 2009 to 2014 using Cox proportional hazards models, both unadjusted and adjusted for age, gender, education, race, and the genetic risk factor APOE-e4.
One hundred seventy-one (6.02%) of the 2842 total HRS respondents with Medicare coverage and genetic data were classified with IMIDs. Over the subsequent 6 years, 9.36% of IMID patients developed AD compared to 8.57% of controls (unadjusted hazard ratio (HR): 1.09, 95% CI .66-1.81, p = 0.74). Adjusted HR 1.27 (95% CI 0.76-2.12, p = 0.35). Age (HR for 10-year increment 3.56, p < .001), less than high school education (HR 1.70, p = .007), and APOE-e4 (HR 2.61, p < .001 for one or two copies), were also statistically significant predictors of AD.
HRS respondents with common IMIDs do not have increased risk of Alzheimer's disease over a 6-year period.
免疫介导的炎症性疾病（IMID）的特征是全身性炎症，会影响关节和身体器官。研究个体IMID与阿尔茨海默病（AD）风险之间的关联，结果并不一致。本研究在一个基于人群的大型老年样本中，考察了一组IMID患者的AD风险。
从健康与退休研究（HRS）中提取了美国50岁以上成年人的全国样本数据，并与2006年至2014年的医疗保险理赔数据相链接。IMID包括类风湿性关节炎、银屑病关节炎、强直性脊柱炎、克罗恩病、溃疡性结肠炎及相关病症。我们使用国际疾病分类（ICD9-CM）编码，从2006年至2009年的医疗保险理赔数据中识别出IMID。AD发病日期源自慢性病数据库（CCW）标识符。我们使用Cox比例风险模型，考察了2009年至2014年AD的风险，模型未调整以及对年龄、性别、教育程度、种族和遗传风险因素APOE-e进行了调整。
在2842名有医疗保险覆盖范围和基因数据的HRS受访者中，171人（6.02%）被归类为患有IMID。在随后的6年里，9.36%的IMID患者患上了AD，而对照组为8.57%（未调整风险比（HR）：1.09，95%置信区间0.66 - 1.81，p = 0.74）。调整后的HR为1.27（95%置信区间0.76 - 2.12，p = 0.35）。年龄（每增加10岁的HR为3.56，p < 0.001）、高中以下学历（HR 1.70，p = 0.007）以及APOE-e4（一份或两份拷贝的HR为2.61，p < 0.001），也是AD的统计学显著预测因素。
患有常见IMID的HRS受访者在6年期间患阿尔茨海默病的风险并未增加。
