类风湿关节炎与慢性阻塞性肺疾病之间的双向关联：一项系统评价和荟萃分析。

Bidirectional association between rheumatoid arthritis and chronic obstructive pulmonary disease: a systematic review and meta-analysis.

作者信息

Wang Meijiao, Pan Hejing, Zhai Yingqi, Li Haichang, Huang Lin, Xie Zhijun, Wen Chengping, Li Xuanlin

机构信息

The Research Institute of Chinese Medicine Clinical Foundation and Immunology, School of Basic Medicine Sciences, Zhejiang Chinese Medical University, Hangzhou, China.

出版信息

Front Immunol. 2024 Dec 2;15:1494003. doi: 10.3389/fimmu.2024.1494003. eCollection 2024.

DOI:10.3389/fimmu.2024.1494003

PMID:39687614

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11647564/

Abstract

BACKGROUND

Rheumatoid arthritis (RA) and chronic obstructive pulmonary disease (COPD) are prevalent and incapacitating conditions, sharing common pathogenic pathways such as tobacco use and pulmonary inflammation. The influence of respiratory conditions including COPD on RA has been observed, meanwhile RA may constituting one of the risk factors for COPD. It unclear that whether a bidirectional associate between RA and COPD. Our study aims to explore the bidirectional relationship between RA and COPD.

METHODS

We systematically searched PubMed, Cochrane Library, and Embase for observational studies from the databases inception to February 20, 2024, utilizing medical subject headings (MeSH) and keywords. We included studies in which RA and COPD were studied as either exposure or outcome variables. Statistical analyses were conducted employing STATA software (version 14.0). The relationship was reported as odds ratios (OR) and corresponding 95% confidence intervals (CI). Publication bias was assessed using funnel plots and Egger's regression.

RESULTS

Nineteen studies with 1,549,181 participants were included. Risk of bias varied from low to moderate, with evidence levels rated as low or very low. Pooled analysis revealed a significant association between RA and increased COPD risk (OR=1.41, 95%CI 1.13 to 1.76, I = 97.8%, =0.003). Subgroup analyses showed similar COPD risk elevations in both of genders, seropositive/seronegative RA, cohort and case control studies. Additionally, there was a significant RA risk increase among those with COPD (OR=1.36, 95%CI 1.05 to 1.76, I = 55.0%, =0.022), particularly among females and seropositive RA, and cohort studies.

CONCLUSION

The meta-analysis identifies a significant bidirectional association between RA and COPD, emphasizing mutually increased risk. Recognizing this connection may can inform proactive approaches to disease prevention and management, potentially reducing the public health burden and improving quality of life.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024518323.

摘要

背景

类风湿关节炎（RA）和慢性阻塞性肺疾病（COPD）是常见且使人丧失能力的疾病，具有吸烟和肺部炎症等共同致病途径。已观察到包括COPD在内的呼吸道疾病对RA的影响，同时RA可能是COPD的危险因素之一。目前尚不清楚RA与COPD之间是否存在双向关联。我们的研究旨在探讨RA与COPD之间的双向关系。

方法

我们系统检索了PubMed、Cochrane图书馆和Embase数据库，以获取从建库至2024年2月20日的观察性研究，使用医学主题词（MeSH）和关键词。我们纳入了将RA和COPD作为暴露或结局变量进行研究的研究。使用STATA软件（版本14.0）进行统计分析。结果以优势比（OR）和相应的95%置信区间（CI）表示。使用漏斗图和Egger回归评估发表偏倚。

结果

纳入了19项研究，共1549181名参与者。偏倚风险从低到中等不等，证据水平被评为低或非常低。汇总分析显示，RA与COPD风险增加之间存在显著关联（OR = 1.41，95%CI 1.13至1.76，I² = 97.8%，P = 0.003）。亚组分析显示，在性别、血清阳性/血清阴性RA、队列研究和病例对照研究中，COPD风险均有类似升高。此外，COPD患者的RA风险显著增加（OR = 1.36，95%CI 1.05至1.76，I² = 55.0%，P = 0.022），尤其是女性和血清阳性RA患者以及队列研究。