Division of Rheumatology, Department of Internal Medicine, Abdurrahman Yurtaslan Oncology Research and Training Hospital, University of Health Sciences, Ankara, Turkiye.
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkiye.
Turk J Med Sci. 2024 Oct 7;54(5):949-955. doi: 10.55730/1300-0144.5872. eCollection 2024.
BACKGROUND/AIM: Rheumatoid factor (RF) and anticitrullinated peptide (anti-CCP) are specific for rheumatoid arthritis (RA) diagnosis. However, they could be positive in other diseases and even in healthy populations. The aim was to investigate the prevalence of positive RF and anti-CCP antibodies in persons admitted to hospital for any reason and on a national scale.
The National Electronic Health Database, which contains the clinical records of over 80 million people, was used to design this multicenter, retrospective cohort study. The subjects included in the study were divided into age groups according to 10-year periods. RA cases were identified using ICD-10 codes that included M05, M06, M08, and their subgroups. RF and anti-CCP positivity were evaluated in terms of their contribution to the risk of being diagnosed with RA, with the change according to age and sex.
During the 1.1.2018-31.12.2021 period, 13,918,072 RF tests were performed in 11,849,440 people, whereas 1,183,607 anti-CCP tests were performed in 1,020,967 people. Moreover, 797,089 people had both tests performed at least once. The RF positivity rate in patients who only requested RF tests was 14.72% and it was 35.04% for anti-CCP positivity in those who only requested anti-CCP tests. The rate of concomitant RF and anti-CCP positivity was 22.56%. An RA diagnosis was made in 27.8% of RF-positive people, 39.73% of anti-CCP-positive people, and 56.6% of co-RF and anti-CCP-positive people. RF positivity and concomitant RF and anti-CCP positivity increased with age and were more common in females.
RF and anti-CCP positivity may be seen in a healthy population with female predominance. As age increases, the risk of RF positivity rises, but anti-CCP positivity does not change. Concomitant RF and anti-CCP positivity shows the highest risk of RA development with respect to either antibody positivity alone.
背景/目的：类风湿因子（RF）和抗瓜氨酸肽（anti-CCP）是类风湿关节炎（RA）诊断的特异性指标。然而，它们也可能在其他疾病中呈阳性，甚至在健康人群中也可能呈阳性。本研究旨在调查在因任何原因住院的人群中，以及在全国范围内，RF 和抗-CCP 抗体阳性的患病率。
本研究采用多中心、回顾性队列设计，利用包含 8000 多万人临床记录的国家电子健康数据库。根据每 10 年一个年龄段将研究对象分为不同的年龄组。RA 病例的识别使用包含 M05、M06、M08 及其亚组的 ICD-10 编码。根据年龄和性别评估 RF 和抗-CCP 阳性对 RA 诊断风险的影响及其变化。
在 2018 年 1 月 1 日至 2021 年 12 月 31 日期间，对 11849440 人进行了 13918072 次 RF 检测，对 1020967 人进行了 1183607 次抗-CCP 检测。此外，797089 人至少进行了一次这两种检测。仅要求进行 RF 检测的患者中 RF 阳性率为 14.72%，仅要求进行抗-CCP 检测的患者中抗-CCP 阳性率为 35.04%。同时 RF 和抗-CCP 阳性的比例为 22.56%。RF 阳性患者中 RA 诊断率为 27.8%，抗-CCP 阳性患者中 RA 诊断率为 39.73%，同时 RF 和抗-CCP 阳性患者中 RA 诊断率为 56.6%。RF 阳性和同时 RF 和抗-CCP 阳性随着年龄的增长而增加，且女性更为常见。
RF 和抗-CCP 阳性可能在以女性为主的健康人群中出现。随着年龄的增长，RF 阳性的风险增加，但抗-CCP 阳性没有变化。同时 RF 和抗-CCP 阳性与单独任何一种抗体阳性相比，RA 发病风险最高。
