第一代和第二代移民中的结节病：瑞典所有18岁及以上成年人的队列研究。

Sarcoidosis in first- and second-generation immigrants: a cohort study of all adults 18 years of age and older in Sweden.

作者信息

Wändell Per, Li Xinjun, Carlsson Axel C, Sundquist Jan, Sundquist Kristina

机构信息

Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge 141 83, Sweden.

Center for Primary Health Care Research, Department of Clinical Sciences, Malmö 205 02, Lund University, Malmö, Sweden.

出版信息

Int Health. 2025 Jan 3;17(1):105-111. doi: 10.1093/inthealth/ihae030.

DOI:10.1093/inthealth/ihae030

PMID:38606589

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11697176/

Abstract

BACKGROUND

There is a lack of studies on sarcoidosis among immigrants, which is of interest as there may be genetic and environmental characteristics affecting immigrants from certain countries. We aimed to study hazard ratios (HRs) of sarcoidosis in first- and second-generation immigrants, comparing them with native Swedes in the total adult Swedish population.

METHODS

We conducted a nationwide study of individuals ≥18 y of age. Sarcoidosis was defined as at least two registered diagnoses in the National Patient Register between 1 January 1998 and 31 December 2018. Cox regression analysis was used to estimate HRs with 99% confidence intervals (CIs) of first registration of sarcoidosis in first- and second-generation immigrants compared with native Swedes. The Cox regression models were stratified by sex and adjusted for age, comorbidities and sociodemographic characteristics.

RESULTS

In total, 6 175 251 were included in the first-generation study, with 12 617 cases of sarcoidosis, and 4 585 529 in the second-generation study, with 12 126 cases. The overall sarcoidosis risk was lower in foreign-born men (fully adjusted HR 0.63 [99% CI 0.57 to 0.69]) but not in foreign-born women (fully adjusted HR 0.98 [99% CI 0.90 to 1.06]). The overall risk was slightly lower in second-generation immigrants (HR 0.82 [99% CI 0.78 to 0.88]). Women from Asia exhibited a higher risk (HR 1.25 [99% CI 1.02 to 1.53)], while a potential trend was observed among women from Africa (HR 1.47 [99% CI 0.99 to 2.19]).

CONCLUSIONS

Sarcoidosis risk was lower in foreign-born men but not in women and also lower in second-generation immigrants.

摘要

背景

目前针对移民人群结节病的研究较少，鉴于某些国家的移民可能具有影响疾病的遗传和环境特征，这一研究颇具意义。我们旨在研究第一代和第二代移民中结节病的风险比（HRs），并将其与瑞典成年总人口中的瑞典本地人进行比较。

方法

我们对年龄≥18岁的个体进行了一项全国性研究。结节病定义为1998年1月1日至2018年12月31日期间在国家患者登记册中至少有两次登记诊断。采用Cox回归分析来估计第一代和第二代移民与瑞典本地人相比首次登记结节病的HRs及99%置信区间（CIs）。Cox回归模型按性别分层，并对年龄、合并症和社会人口学特征进行了调整。

结果

第一代研究共纳入6175251人，其中结节病患者12617例；第二代研究共纳入4585529人，其中结节病患者12126例。外国出生男性的总体结节病风险较低（完全调整后的HR为0.63[99%CI为0.57至0.69]），但外国出生女性的风险不低（完全调整后的HR为0.98[99%CI为0.90至1.06]）。第二代移民的总体风险略低（HR为0.82[99%CI为0.78至0.88]）。亚洲女性的风险较高（HR为1.25[99%CI为1.02至1.53]），而非洲女性中观察到了潜在趋势（HR为1.47[99%CI为0.99至2.19]）。