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西班牙裔人群中巨细胞动脉炎的发病率、特征以及缺血性眼部事件和中风的相关结局。

The incidence and characteristics of giant cell arteritis in Hispanics and the associated outcomes of ischemic ocular events and stroke.

作者信息

Smith Lisa M, Alvarado Luis A, Dihowm Fatma

机构信息

Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso, TX, USA.

Biostatistics and Epidemiology and Consulting Lab, Office of Research, Texas Tech University Health Science Center El Paso, El Paso, TX, USA.

出版信息

J Investig Med. 2023 Apr;71(4):411-418. doi: 10.1177/10815589231152821. Epub 2023 Jan 29.

Abstract

Giant cell arteritis (GCA) is a large vessel vasculitis whereby up to half of all patients show ocular involvement, highlighting the importance of treating GCA before it leads to irreversible blindness. Most of the research published for GCA and associated adverse ocular events are based on majority Caucasian populations establishing the current belief that Hispanics have a much lower incident of GCA. We sought to investigate the incidence of GCA in Hispanics and characterize associated ocular events, stroke rates, and comorbid diseases. We conducted a retrospective cohort study of GCA-coded medical records in self-identified Hispanics assessed at the University Medical Center Hospital in El Paso, Texas. From 2000 to 2019, there were 68 new cases of GCA in the Hispanics which represents an average incidence of 0.062% with a 95% confidence interval of [0.05, 0.09] of Hispanics over the age of 50 admitted to University Medical Center hospital. Of the subjects diagnosed with GCA, the majority had ocular involvement such as blurry vision (47.06%), ocular pain (26.47%), and blindness (14.71%). We did not observe a history of stroke had a statistically significant difference associated with GCA with ophthalmic disease compared to GCA without ophthalmic disease. Polymyalgia rheumatica (PMR) was identified in only 2.94% of the Hispanic subjects with GCA. Major conclusions in our study advocate Hispanics with GCA are prevalent and unique in its associations with other comorbid diseases. Unlike non-Hispanic White populations, Hispanic subjects with GCA do not show an association with PMR nor an increased association with stroke.

摘要

巨细胞动脉炎(GCA)是一种大血管血管炎,高达一半的患者会出现眼部受累,这凸显了在GCA导致不可逆失明之前进行治疗的重要性。大多数关于GCA及相关不良眼部事件的研究是基于多数为白种人的人群,这使得人们目前认为西班牙裔人群中GCA的发病率要低得多。我们旨在调查西班牙裔人群中GCA的发病率,并对相关的眼部事件、中风发生率和合并疾病进行特征描述。我们对在得克萨斯州埃尔帕索大学医学中心医院接受评估的自我认定为西班牙裔的、编码为GCA的医疗记录进行了一项回顾性队列研究。2000年至2019年期间,西班牙裔人群中有68例新的GCA病例,这代表50岁以上入住大学医学中心医院的西班牙裔人群的平均发病率为0.062%,95%置信区间为[0.05, 0.09]。在被诊断为GCA的受试者中,大多数有眼部受累情况,如视力模糊(47.06%)、眼痛(26.47%)和失明(14.71%)。我们没有观察到有中风病史与患有眼科疾病的GCA之间存在统计学上的显著差异,与没有眼科疾病的GCA相比也是如此。在患有GCA的西班牙裔受试者中,仅2.94%被诊断出患有风湿性多肌痛(PMR)。我们研究的主要结论表明,患有GCA的西班牙裔人群很普遍,并且在与其他合并疾病的关联方面具有独特性。与非西班牙裔白人人群不同,患有GCA的西班牙裔受试者与PMR没有关联,与中风的关联也没有增加。

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