Chang Ching-Mao, Lin Jr-Rung, Fu Tieh-Cheng
Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Front Med (Lausanne). 2022 Jun 28;9:882911. doi: 10.3389/fmed.2022.882911. eCollection 2022.
To evaluate associations between sarcopenia, type of autoimmune disease and risk of heart failure (HF) and myocardial infarction (MI) in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA).
In this population-based, cross-sectional study, discharge data from the 2005-2014 US Nationwide Inpatient Sample (NIS) of hospitalized patients with SLE or RA were extracted and analyzed. Univariate and multivariable regression analyses were conducted to determine associations between sarcopenia, type of autoimmune disease and risk of HF/MI.
After exclusions, 781,199 hospitalized patients diagnosed with SLE or RA were included. Among the study cohort, 127,812 (16.4%) were hospitalized with HF, and 12,781 (1.6%) were hospitalized with MI. Sarcopenia was found in only 0.1% of HF/MI patients. Logistic regression analyses revealed that sarcopenia was not significantly associated with presence of either HF or MI. Patients with RA had significantly lower odds of HF than SLE patients (aOR = 0.77, 95%CI: 0.76, 0.79) or MI (aOR = 0.86, 95%CI: 0.82, 0.91).
In the US, among hospitalized adults diagnosed with SLE or RA, patients with RA are significantly less likely to have HF or MI than those with SLE. Whether sarcopenia leads to increased HF or MI remains inconclusive. Further studies are warranted to investigate the pathophysiology underlying discrepancies between RA and SLE regarding risk for MI or HF.
评估系统性红斑狼疮（SLE）和类风湿关节炎（RA）患者中肌肉减少症、自身免疫性疾病类型与心力衰竭（HF）及心肌梗死（MI）风险之间的关联。
在这项基于人群的横断面研究中，提取并分析了2005 - 2014年美国全国住院患者样本（NIS）中SLE或RA住院患者的出院数据。进行单变量和多变量回归分析以确定肌肉减少症、自身免疫性疾病类型与HF/MI风险之间的关联。
排除后，纳入了781,199例诊断为SLE或RA的住院患者。在研究队列中，127,812例（16.4%）因HF住院，12,781例（1.6%）因MI住院。仅0.1%的HF/MI患者存在肌肉减少症。逻辑回归分析显示，肌肉减少症与HF或MI的存在均无显著关联。RA患者发生HF的几率显著低于SLE患者（调整后比值比[aOR]=0.77，95%置信区间[CI]：0.76，0.79）或MI（aOR = 0.86，95%CI：0.82，0.91）。
在美国，在诊断为SLE或RA的住院成年人中，RA患者发生HF或MI的可能性显著低于SLE患者。肌肉减少症是否会导致HF或MI增加仍无定论。有必要进一步研究调查RA和SLE在MI或HF风险方面差异的病理生理学基础。
