Chen Chia-Lun, Chang Fang-Cherng, Hung Yao-Min, Chou Mei-Chia, Yip Hei-Tung, Chang Renin, Wei James Cheng-Chung
Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
Front Med (Lausanne). 2022 Jan 21;8:796324. doi: 10.3389/fmed.2021.796324. eCollection 2021.
infection is prevalent in patients with Sjögren's syndrome (SjS), which usually takes years to reach diagnosis. Is the link a two-way street? The role of infection before SjS has not been examined clearly. This study was conducted to provide epidemiological evidence regarding the relationship between the first acquisition of infection and subsequent SjS.
Totally, 23,494 individuals newly diagnosed with infection were enrolled from 2000, to 2012. Controls ( = 93,976) were selected at a 1:4 ratio through propensity score matched (PSM) using the greedy algorithm. Exposure was defined according to the codes.
SjS was recorded in the Registry for Catastrophic Illness Patients Database (RCIPD). Cox proportional hazard model was used to analyze the association and sensitivity analyses for cross-validation.
Of 117,470 individuals (106,077 [89%] women), 23,494 individuals (20.0%) had infection and 104 individuals (0.1%) developed SjS. The incidence of SjS was higher in the exposed group compared with the controls (1.92 vs. 0. 98 per 10,000 person-years) with adjusted hazard ratio (aHR) 1.90 (95% CI, 1.25-2.87). The aHRs in subgroups of aged 18-30 years, oral candidiasis and depression were 4.30 (95% CI, 1.60-11.55), 4.70 (4.70-13.93) and 6.34 (2.16-18.66). Sensitivity analyses yield consistent results.
Residents in Taiwan with infection have higher risk of SjS. For early diagnosis of SjS, clinicians are advised to take infection into account in some situation.
感染在干燥综合征（SjS）患者中很常见，通常需要数年时间才能确诊。这种联系是双向的吗？SjS发病前感染的作用尚未得到明确研究。本研究旨在提供关于首次感染与随后发生SjS之间关系的流行病学证据。
总共从2000年至2012年纳入23494例新诊断为感染的个体。通过倾向评分匹配（PSM）使用贪婪算法以1:4的比例选择对照（n = 93976）。根据感染编码定义暴露情况。
在重大疾病患者登记数据库（RCIPD）中记录SjS。使用Cox比例风险模型分析关联并进行交叉验证的敏感性分析。
在117470例个体（106077例[89%]为女性）中，23494例个体（20.0%）有感染，104例个体（0.1%）发生SjS。与对照组相比，暴露组SjS的发病率更高（每10000人年1.92例对0.98例），调整后的风险比（aHR）为1.90（95%CI，1.25 - 2.87）。18 - 30岁亚组、口腔念珠菌病和抑郁症亚组的aHR分别为4.30（95%CI，1.60 - 11.55）、4.70（4.70 - 13.93）和6.34（2.16 - 18.66）。敏感性分析得出一致结果。
台湾地区感染的居民患SjS的风险更高。为了早期诊断SjS，建议临床医生在某些情况下考虑感染因素。
