Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seoul, Seongdong-gu, 04763, Republic of Korea.
Arthritis Res Ther. 2023 Oct 23;25(1):209. doi: 10.1186/s13075-023-03189-2.
The association between systemic sclerosis and the development of bronchiectasis is unclear. This study aimed to compare the risk of bronchiectasis between individuals with systemic sclerosis and those without using a nationwide longitudinal dataset.
Using the Korean National Health Insurance Service dataset between 2010 and 2017, we identified 4845 individuals aged ≥ 20 years with systemic sclerosis and 24,225 without systemic sclerosis who were matched 1:5 by age and sex. They were followed up until the date of a bronchiectasis diagnosis, death, or December 31, 2019, whichever came first.
During a median follow-up period of 6.0 (interquartile range, 3.2-8.7) years, 5.3% of the systemic sclerosis cohort and 1.9% of the matched cohort developed bronchiectasis, with incidence rates of 9.99 and 3.23 per 1000 person-years, respectively. Even after adjusting for potential confounders, the risk of incident bronchiectasis was significantly higher in the systemic sclerosis cohort than in the matched cohort (adjusted hazard ratio 2.63, 95% confidence interval 2.22-3.12). A subgroup analysis of individuals with systemic sclerosis revealed that the risk of incident bronchiectasis was notably higher in younger individuals aged 20-39 years (P for interaction = 0.048) and in those without other coexisting connective tissue diseases (P for interaction = 0.006) than in their counterparts.
The risk of incident bronchiectasis is higher in individuals with systemic sclerosis than those without. Bronchiectasis should be considered one of the pulmonary manifestations related to systemic sclerosis.
系统性硬化症与支气管扩张症的发生之间的关联尚不清楚。本研究旨在使用全国性纵向数据集比较系统性硬化症患者和无系统性硬化症患者发生支气管扩张症的风险。
使用韩国国家健康保险服务数据集（2010 年至 2017 年），我们确定了 4845 名年龄≥20 岁的系统性硬化症患者和 24225 名无系统性硬化症患者，他们按年龄和性别 1:5 匹配。随访至支气管扩张症诊断、死亡或 2019 年 12 月 31 日（以先发生者为准）。
在中位随访期为 6.0 年（四分位间距 3.2-8.7 年）内，系统性硬化症队列中有 5.3%的患者和匹配队列中有 1.9%的患者发生了支气管扩张症，发生率分别为 9.99 和 3.23/1000人年。即使在校正了潜在混杂因素后，系统性硬化症队列的支气管扩张症发病风险仍明显高于匹配队列（校正后的发病风险比 2.63，95%置信区间 2.22-3.12）。对系统性硬化症患者的亚组分析显示，年龄在 20-39 岁的年轻患者（交互 P 值=0.048）和无其他共存结缔组织病的患者（交互 P 值=0.006）发生支气管扩张症的风险显著更高。
与无系统性硬化症的患者相比，系统性硬化症患者发生支气管扩张症的风险更高。支气管扩张症应被视为与系统性硬化症相关的肺部表现之一。
