Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain; UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain; UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain.
Biomed Pharmacother. 2023 Jan;157:114049. doi: 10.1016/j.biopha.2022.114049. Epub 2022 Nov 29.
To describe comorbid conditions in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and to analyze factors associated with multimorbidity.
Nested case-cohort study of 2 prospective cohorts: one with RA-ILD (cases) and another with RA but not ILD (controls). The cohorts were matched for age, sex, and time since diagnosis. Multimorbidity was defined as the co-occurrence of 2 or more chronic diseases, in addition to RA and ILD. We evaluated the comorbid conditions included in the Charlson Comorbidity Index, cardiovascular risk factors, neuropsychiatric conditions, and other frequent conditions in RA. We also recorded clinical-laboratory variables, inflammatory activity according to the 28-joint Disease Activity Score, C-reactive protein (CRP), physical function, and pulmonary function. We performed 2 multivariate analyses to identify factors associated with multimorbidity in RA and RA-ILD.
The final study population comprised 110 cases and 104 controls. Multimorbidity was more frequent among cases than controls (80 [72.7] vs 60 [57.7]; p = 0.021). In both groups, multimorbidity was associated with ILD (OR [95% CI] 1.92 [1.03-3.59]; p = 0.039), age (OR [95% CI] 1.05 [1.01-1.08]; p = 0.004), CRP (OR [95% CI] 1.16 [1.05-1.29]; p = 0.003), and erosions (OR [95% CI] 1.05 [1.01-1.08]; p = 0.004); in the cases, it was associated with CRP (OR [95% CI] 1.17 [1.01-1.35]; p = 0.027), anti-citrullinated peptide antibody (OR [95% CI] 1.23 [1.14-13.02]; p = 0.049), and forced vital capacity (OR [95% CI] 0.79 [0.96-0.99]; p = 0.036).
In patients with RA, multimorbidity was associated with ILD, systemic inflammation, and advanced age.
描述类风湿关节炎相关间质性肺病（RA-ILD）患者的合并症，并分析与多种合并症相关的因素。
这是一项嵌套病例对照研究，纳入了两个前瞻性队列：一个是 RA-ILD 队列（病例），另一个是 RA 但无 ILD 队列（对照）。队列按年龄、性别和诊断后时间进行匹配。多种合并症定义为除 RA 和 ILD 以外，同时存在两种或更多种慢性疾病。我们评估了 Charlson 合并症指数中包含的合并症、心血管危险因素、神经精神疾病和 RA 中常见的其他疾病。我们还记录了临床-实验室变量、28 关节疾病活动评分（DAS28）所示的炎症活动、C 反应蛋白（CRP）、身体功能和肺功能。我们进行了两次多变量分析，以确定 RA 和 RA-ILD 中与多种合并症相关的因素。
最终的研究人群包括 110 例病例和 104 例对照。病例组的多种合并症发生率高于对照组（80 [72.7] vs 60 [57.7]；p=0.021）。在两组中，多种合并症均与 ILD 相关（比值比[95%可信区间] 1.92 [1.03-3.59]；p=0.039）、年龄（比值比[95%可信区间] 1.05 [1.01-1.08]；p=0.004）、CRP（比值比[95%可信区间] 1.16 [1.05-1.29]；p=0.003）和侵蚀（比值比[95%可信区间] 1.05 [1.01-1.08]；p=0.004）；在病例组中，还与 CRP（比值比[95%可信区间] 1.17 [1.01-1.35]；p=0.027）、抗瓜氨酸化蛋白抗体（比值比[95%可信区间] 1.23 [1.14-13.02]；p=0.049）和用力肺活量（比值比[95%可信区间] 0.79 [0.96-0.99]；p=0.036）相关。
在 RA 患者中，多种合并症与 ILD、全身炎症和高龄有关。
