Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.
Scand J Rheumatol. 2023 Jul;52(4):327-334. doi: 10.1080/03009742.2022.2058178. Epub 2022 May 12.
Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology that affects approximately 1% of the population. The disease presents a temporal variability in different geographic areas. We investigated RA incidence over a 40-year-period in a defined area of north-west Greece, with a total population of about 400 000 inhabitants.
This incidence study was based on retrospective review of clinical records among adults with RA newly diagnosed from 1980 to 2019 at the referral university hospital of Ioannina. An incident case was defined as any patient diagnosed with RA based on the 1987 American College of Rheumatology criteria, over 16-years-old, and resident in the study area for at least 1 year before diagnosis.
Out of 1411 cases diagnosed, women constituted a 2.65-fold higher number than men, with a lower mean age at diagnosis. The overall age-adjusted annual incidence rate (95% confidence interval) was 9.5 (8.5-10.5) for the total observation period, 11.7 (10.7-13.0) in 1980-1989, 10.4 (9.4-10.8) in 1990-1999, 9.8 (8.9-10.8) in 2000-2009, and 6.1 (5.3-6.9) in 2010-2019, presenting a statistically significant decline over time, along with a constant decrease in rheumatoid factor (RF)-positive incidence for both sexes.
Our findings suggest a decrease in the incidence of RA over 40 years in a geographically defined Greek population. Also, the progressive decrease in the incidence of RF-positive disease may relate to less severe expression of RA in Greek patients. These trends could be explained by different clinical, serological, and genetic factors reported in Greece compared to northern European countries.
类风湿关节炎（RA）是一种病因不明的慢性炎症性疾病，影响约 1%的人口。该疾病在不同地理区域呈现出时间上的可变性。我们在希腊西北部一个约 40 万居民的特定地区调查了 40 年来 RA 的发病率。
这项发病率研究基于对 1980 年至 2019 年期间在伊奥尼亚纳转诊大学医院新诊断为 RA 的成年患者的临床记录进行回顾性分析。一个发病病例被定义为任何根据 1987 年美国风湿病学会标准诊断为 RA 的患者，年龄超过 16 岁，在诊断前至少在研究区域居住 1 年以上。
在诊断出的 1411 例病例中，女性人数是男性的 2.65 倍，诊断时的平均年龄较低。在整个观察期间，经年龄调整的年发病率（95%置信区间）为 9.5（8.5-10.5），1980-1989 年为 11.7（10.7-13.0），1990-1999 年为 10.4（9.4-10.8），2000-2009 年为 9.8（8.9-10.8），2010-2019 年为 6.1（5.3-6.9），发病率随时间呈统计学显著下降，同时男女 RF 阳性发病率也持续下降。
我们的研究结果表明，在一个地理上确定的希腊人群中，40 年来 RA 的发病率呈下降趋势。此外，RF 阳性疾病发病率的逐渐下降可能与希腊患者 RA 的表达更为轻微有关。与北欧国家相比，在希腊报道的不同临床、血清学和遗传因素可能解释了这些趋势。
