衰老对类风湿关节炎患者类风湿因子和抗环瓜氨酸肽抗体阳性率的影响。
Effects of Aging on Rheumatoid Factor and Anticyclic Citrullinated Peptide Antibody Positivity in Patients With Rheumatoid Arthritis.
机构信息
S. Takanashi, MD, PhD, T. Takeuchi, MD, PhD, Y. Kaneko, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
出版信息
J Rheumatol. 2023 Mar;50(3):330-334. doi: 10.3899/jrheum.220526. Epub 2022 Nov 1.
OBJECTIVE
We investigated the factors that affect rheumatoid factor (RF) and anticyclic citrullinated peptide antibody (anti-CCP) positivity in patients with rheumatoid arthritis (RA).
METHODS
The study included all consecutive patients with RA treated at Keio University Hospital between 2016 and 2017. We recorded age at diagnosis, sex, smoking habit, BMI (kg/m), and family history, and investigated the association between these variables and RF and anti-CCP positivity.
RESULTS
We recruited 1685 patients with RA. The mean age at diagnosis was 51.9 years, and 83.4% of the patients were women. Positivity rates of RF and anti-CCP almost linearly decreased along with the increase in age at RA diagnosis (grouped by decade) after ≥ 30 years of age (RF: 80.5%, 84.2%, 81.1%, 78%, 74.6%, 62.6%, 51.4%, < 0.001; anti-CCP: 79.9%, 87.4%, 81.7%, 74%, 70.5%, 60.2%, 37.1%; < 0.001). Multivariable analysis revealed that age was independently associated with seronegativity in women (RF: odds ratio [OR] 0.98, 95% CI 0.97-0.99, < 0.001; anti-CCP: OR 0.97, 95% CI 0.96-0.98; < 0.001), nonsmoking history (RF: OR 0.98, 95% CI 0.97-0.99, < 0.001; anti-CCP: OR 0.97, 95% CI 0.96-0.98; < 0.001), and BMI < 25 (RF: OR 0.98, 95% CI 0.97-0.99; < 0.001; anti-CCP: OR 0.97, 95% CI 0.97-0.98; < 0.001).
CONCLUSION
Aging is an independent contributor for seronegative RA in patients who are female, have a nonsmoking history, and a BMI < 25.
目的
我们研究了影响类风湿关节炎（RA）患者类风湿因子（RF）和抗环瓜氨酸肽抗体（抗-CCP）阳性的因素。
方法
本研究纳入了 2016 年至 2017 年期间在庆应义塾大学医院接受治疗的所有连续 RA 患者。我们记录了患者的诊断年龄、性别、吸烟习惯、BMI（kg/m）和家族史，并调查了这些变量与 RF 和抗-CCP 阳性之间的关联。
结果
我们共招募了 1685 例 RA 患者。诊断时的平均年龄为 51.9 岁，83.4%的患者为女性。RF 和抗-CCP 的阳性率几乎呈线性下降，随着 RA 诊断年龄（每十年分组）的增加，在≥30 岁后（RF：80.5%、84.2%、81.1%、78%、74.6%、62.6%、51.4%，<0.001；抗-CCP：79.9%、87.4%、81.7%、74%、70.5%、60.2%、37.1%，<0.001）。多变量分析显示，年龄与女性的血清阴性状态独立相关（RF：比值比[OR]0.98，95%置信区间[CI]0.97-0.99，<0.001；抗-CCP：OR 0.97，95%CI 0.96-0.98，<0.001），非吸烟史（RF：OR 0.98，95%CI 0.97-0.99，<0.001；抗-CCP：OR 0.97，95%CI 0.96-0.98，<0.001）和 BMI<25（RF：OR 0.98，95%CI 0.97-0.99，<0.001；抗-CCP：OR 0.97，95%CI 0.97-0.98，<0.001）。
结论
在女性、无吸烟史和 BMI<25 的患者中，年龄是 RA 血清阴性的独立影响因素。
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