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糖尿病对类风湿关节炎治疗及5年随访结局的影响:来自多民族亚洲队列的结果

The impact of diabetes mellitus on treatment and outcomes of rheumatoid arthritis at 5-year follow-up: results from a multi-ethnic Asian cohort.

作者信息

Xu Chuanhui, Yong Mei Yun, Koh Ee Tzun, Dalan Rinkoo, Leong Khai Pang

机构信息

Department of Rheumatology, Allergy and Immunology.

Department of Endocrinology, Tan Tock Seng Hospital, Singapore.

出版信息

Rheumatol Adv Pract. 2021 Nov 4;5(3):rkab077. doi: 10.1093/rap/rkab077. eCollection 2021.

Abstract

OBJECTIVES

We evaluated the impact of type 2 diabetes mellitus (T2DM) on RA treatment and outcomes in a longitudinal RA cohort.

METHODS

We analysed data collected in the period 2001-2013 involving 583 RA patients, including demographics, diabetes diagnosis, clinical features, treatment, ACR functional class, HAQ, and quality-of-life measurement using the Short-Form 36.

RESULTS

Seventy-seven (13.2%) of the RA patients had T2DM. DAS28 was not different in patients with T2DM at 5 years post-RA diagnosis. Fewer T2DM patients received MTX than those without T2DM (51% 80%, < 0.001). Using univariate analysis, T2DM patients were more likely to experience poorer outcomes in terms of ACR functional status ( = 0.009), joint surgery ( = 0.007), knee arthroplasty ( < 0.001) and hospital admissions ( = 0.006). Multivariate regression analyses showed more knee arthroplasty ( = 0.047) in patients with T2DM.

CONCLUSION

Fewer patients with T2DM received MTX compared with those without T2DM. Patients with RA and T2DM were at higher risk of knee arthroplasty than RA patients without T2DM.

摘要

目的

我们在一个类风湿关节炎(RA)纵向队列中评估了2型糖尿病(T2DM)对RA治疗及预后的影响。

方法

我们分析了2001年至2013年期间收集的涉及583例RA患者的数据,包括人口统计学信息、糖尿病诊断、临床特征、治疗情况、美国风湿病学会(ACR)功能分级、健康评估问卷(HAQ)以及使用简明健康调查问卷(SF-36)进行的生活质量测量。

结果

77例(13.2%)RA患者患有T2DM。RA诊断后5年时,T2DM患者的疾病活动度评分(DAS28)与非T2DM患者无差异。接受甲氨蝶呤(MTX)治疗的T2DM患者少于非T2DM患者(51%对80%,P<0.001)。单因素分析显示,T2DM患者在ACR功能状态(P=0.009)、关节手术(P=0.007)、膝关节置换术(P<0.001)和住院治疗(P=0.006)方面更可能出现较差的预后。多因素回归分析显示T2DM患者进行膝关节置换术的比例更高(P=0.047)。

结论

与非T2DM患者相比,接受MTX治疗的T2DM患者较少。与无T2DM的RA患者相比,患有RA和T2DM的患者进行膝关节置换术的风险更高。

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