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炎症性肠病与多发性肌炎和皮肌炎相关:一项回顾性队列分析。

Inflammatory Bowel Diseases Are Associated with Polymyositis and Dermatomyositis-A Retrospective Cohort Analysis.

机构信息

Department of Gastroenterology, Sheba Medical Centre, Tel-Hashomer 5265601, Israel.

Department of Medicine B, Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer 5262100, Israel.

出版信息

Medicina (Kaunas). 2022 Nov 25;58(12):1727. doi: 10.3390/medicina58121727.

Abstract

: Polymyositis and dermatomyositis (PM/DM) are classified as polygenic autoimmune diseases, whereas inflammatory bowel disease (IBD) is considered a polygenic autoinflammatory disease. In the literature, several cases exist reporting the co-occurrence of both conditions. At the molecular level, PM/DM and IBD share common genetic determinants including interferon regulatory factor and vitamin D receptor susceptibility loci. Accumulating evidence underline several indicators that confer poor prognosis in IBD, including antinuclear antibody positivity and the presence of other autoimmune diseases, therefore the aim of this study is to assess the association between these entities. : This is a population-based retrospective study using data retrieved from a large electronic medical record in Israel, the Clalit health registry. The sample included PM/DM patients and age- and sex-frequency matched controls. The prevalence of IBD in PM/DM was compared between the two groups and logistic regression was applied to control for confounding variables. Predictors of IBD in patients with PM/DM were also explored. : Our study included 12,278 subjects with 2085 PM/DM patients and 10,193 age- and sex- frequency-matched controls. The incidence of IBD in patients with PM/DM was significantly higher even after controlling for various confounding variables (OR of 1.73, 95% CI 1.05-2.86, -value = 0.033). Anti-nuclear antibodies (ANA) positivity was found to be an independent predictor for IBD diagnosis in patients with PM/DM (OR 3.67, 95% CI 1.01-13.36, = 0.048). : Our analysis reports an association between IBD and PM/DM. Such association could point towards a common pathophysiological background. Further research is needed to further describe the clinical courses and whether a unique therapeutic approach is warranted.

摘要

多发性肌炎和皮肌炎(PM/DM)被归类为多基因自身免疫性疾病,而炎症性肠病(IBD)被认为是多基因自身炎症性疾病。在文献中,有几例报告同时存在这两种情况。在分子水平上,PM/DM 和 IBD 具有共同的遗传决定因素,包括干扰素调节因子和维生素 D 受体易感基因座。越来越多的证据强调了一些在 IBD 中预示预后不良的指标,包括抗核抗体阳性和其他自身免疫性疾病的存在,因此本研究旨在评估这些实体之间的关联。

这是一项基于人群的回顾性研究,使用从以色列大型电子病历——Clalit 健康登记处获取的数据。样本包括 PM/DM 患者和年龄及性别频数匹配的对照。比较了两组患者中 IBD 的患病率,并应用逻辑回归控制混杂变量。还探讨了 PM/DM 患者中 IBD 的预测因素。

我们的研究纳入了 12278 名受试者,其中 2085 名 PM/DM 患者和 10193 名年龄及性别频数匹配的对照。即使在控制了各种混杂变量后,PM/DM 患者的 IBD 发病率仍显著升高(比值比为 1.73,95%置信区间为 1.05-2.86,P 值=0.033)。抗核抗体(ANA)阳性被发现是 PM/DM 患者 IBD 诊断的独立预测因素(比值比为 3.67,95%置信区间为 1.01-13.36,P 值=0.048)。

我们的分析报告了 IBD 和 PM/DM 之间的关联。这种关联可能指向共同的病理生理背景。需要进一步研究以进一步描述其临床过程,以及是否需要独特的治疗方法。

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