Muntyanu Anastasiya, Milan Raymond, Rahme Elham, LaChance Avery, Ouchene Lydia, Cormier Maxime, Litvinov Ivan V, Hudson Marie, Baron Murray, Netchiporouk Elena
Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, QC, Canada.
Front Med (Lausanne). 2022 Sep 29;9:984907. doi: 10.3389/fmed.2022.984907. eCollection 2022.
Systemic sclerosis (SSc) is thought to be induced by an environmental trigger in genetically predisposed individuals. This study assessed the demographic and clinical characteristics and disease severity of silica exposed SSc patients.
Data was obtained from the Canadian Scleroderma Research Group (CSRG) cohort, containing 1,439 patients (2004-2019). Univariate and multivariate logistic regression analyses were performed, to determine the phenotype and severity of silica-exposed SSc patients. Mortality was assessed using Cox Survival Regression and Kaplan-Meier analyses.
Among 1,439 patients (86.7% females), 95 patients reported exposure to silica. Those exposed were younger, of male sex and with more severe disease. Sex differences were observed where male patients exposed to silica were more likely to be Caucasian and smokers whereas female patients were younger at SSc diagnosis compared to unexposed. Multivariate regression, controlled for multiple confounders, showed that silica exposure was associated with a younger age at diagnosis and worse disease severity and mortality.
Exposure to silica was reported in ∼7% of CSRG cohort and ∼20% of male patients and was associated with a worse prognosis in terms of age of diagnosis, organ involvement and mortality. Hence, screening for silica exposure among higher risk individuals may be beneficial and these patients may require closer monitoring for systemic disease.
系统性硬化症（SSc）被认为是由环境触发因素在具有遗传易感性的个体中诱发的。本研究评估了接触二氧化硅的SSc患者的人口统计学和临床特征以及疾病严重程度。
数据来自加拿大硬皮病研究组（CSRG）队列，该队列包含1439名患者（2004 - 2019年）。进行单变量和多变量逻辑回归分析，以确定接触二氧化硅的SSc患者的表型和严重程度。使用Cox生存回归和Kaplan - Meier分析评估死亡率。
在1439名患者中（86.7%为女性），95名患者报告接触过二氧化硅。接触二氧化硅的患者更年轻，为男性，且疾病更严重。观察到性别差异，接触二氧化硅的男性患者更可能是白种人和吸烟者，而与未接触者相比，女性患者在SSc诊断时更年轻。在控制了多个混杂因素的多变量回归分析中，显示接触二氧化硅与诊断时年龄较小、疾病严重程度更差和死亡率更高相关。
在CSRG队列中约7%的患者以及约20%的男性患者报告接触过二氧化硅，并且在诊断年龄、器官受累和死亡率方面与更差的预后相关。因此，对高危个体筛查二氧化硅接触情况可能有益，并且这些患者可能需要对全身性疾病进行更密切的监测。
