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皮肤红斑狼疮患者的多自身免疫性:一项来自丹麦的全国性性别和年龄匹配队列研究。

Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark.

作者信息

Graven-Nielsen Christoffer S, Vittrup Ida V, Kragh Anna J, Lund Fredrik, Bliddal Sofie, Kofoed Kristian, Kristensen Salome, Stensballe Allan, Nielsen Claus H, Feldt-Rasmussen Ulla, Cordtz René, Dreyer Lene

机构信息

Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark.

Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.

出版信息

JAAD Int. 2023 Aug 25;13:126-133. doi: 10.1016/j.jdin.2023.07.018. eCollection 2023 Dec.

Abstract

BACKGROUND

Polyautoimmunity is defined as having 2 or more autoimmune diseases. Little is known about polyautoimmunity in patients with cutaneous lupus erythematosus (CLE).

OBJECTIVES

To estimate prevalence and 5-year incidence of non-lupus erythematosus (LE) autoimmune diseases in patients with CLE.

METHODS

Patients with CLE were identified In the Danish National Patient Registry and each patient was age- and sex-matched with 10 general population controls. Outcome information on non-LE autoimmune diseases was obtained by register-linkage between Danish National Patient Registry and the National Prescription Register. The risk ratio (RR) for prevalent non-LE autoimmune disease at time of CLE diagnosis was calculated in modified Poisson regression; and hazard ratios (HRs) for incident non-LE autoimmune disease were estimated in Cox regression analyses.

RESULTS

Overall, 1674 patients with CLE had a higher prevalence of a non-LE autoimmune disease than the comparators (18.5 vs 7.9%; RR 2.4; 95% CI, 2.1 to 2.6). Correspondingly, the cumulative incidence of a non-LE autoimmune disease during 5 years of follow-up was increased for the patients with CLE: HR 3.5 (95% CI, 3.0 to 4.0).

LIMITATIONS

Risk of detection and misclassification bias, mainly pertaining to the CLE group.

CONCLUSION

Patients with CLE had higher prevalence and 5-year cumulative incidence of a non-LE autoimmune disease than the general population.

摘要

背景

多自身免疫性被定义为患有两种或更多自身免疫性疾病。关于皮肤红斑狼疮(CLE)患者的多自身免疫性,人们了解甚少。

目的

评估CLE患者中非红斑狼疮(LE)自身免疫性疾病的患病率和5年发病率。

方法

在丹麦国家患者登记处识别出CLE患者,并将每位患者按年龄和性别与10名普通人群对照进行匹配。通过丹麦国家患者登记处与国家处方登记处之间的登记关联,获取非LE自身免疫性疾病的结局信息。在修正泊松回归中计算CLE诊断时非LE自身免疫性疾病的患病风险比(RR);在Cox回归分析中估计非LE自身免疫性疾病发病的风险比(HR)。

结果

总体而言,1674例CLE患者中非LE自身免疫性疾病的患病率高于对照组(18.5%对7.9%;RR 2.4;95%可信区间,2.1至2.6)。相应地,CLE患者在5年随访期间非LE自身免疫性疾病的累积发病率增加:HR 3.5(95%可信区间,3.0至4.0)。

局限性

存在检测风险和错误分类偏倚,主要与CLE组有关。

结论

CLE患者中非LE自身免疫性疾病的患病率和5年累积发病率高于普通人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12f8/10550802/7dd0a15bde44/gr1.jpg

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