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口服避孕药的使用与类风湿关节炎发病之间的关联:一项系统评价与荟萃分析

Association Between the Use of Oral Contraceptives and the Development of Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

作者信息

Marino Annalisa, Currado Damiano, Berardicurti Onorina, Vomero Marta, Kun Lyubomyra, Di Corcia Letizia Pia, Corberi Erika, Trunfio Francesca, Saracino Francesca, Lamberti Ludovica, Frascà Leonardo, Battista Angelo, Alfano Marta, Pietramale Manuela, Schiavone Silvia, Giacomelli Roberto, Navarini Luca

机构信息

Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.

Rheumatology and Clinical Immunology, Department of Medicine, University of Rome "Campus Biomedico", School of Medicine, 00128 Rome, Italy.

出版信息

J Clin Med. 2025 Apr 15;14(8):2710. doi: 10.3390/jcm14082710.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that significantly impacts quality of life, particularly among women. Previous studies have suggested that oral contraceptive (OC) use may influence RA risk, but conflicting findings from earlier meta-analyses necessitate an updated analysis incorporating more recent data. We conducted a systematic review and meta-analysis of observational studies on OC use and RA risk by searching MedLine (via PubMed), Scopus, and Cochrane Databases up to September 2024. Our analysis demonstrated that current or prior use of OCs is associated with a statistically significant reduction in RA risk (OR 0.80, 95% CI 0.70-0.91). In contrast, the associations for current use (OR 0.59, 95% CI 0.34-1.02) and past use (OR 0.83, 95% CI 0.69-1.01) were less definitive, likely due to substantial heterogeneity among studies. Cumulative meta-analysis revealed a modest temporal trend toward a protective effect of OC use. This meta-analysis supports a protective association between current or prior OC use and the development of RA, highlighting the potential role of hormonal factors in RA pathogenesis.

摘要

类风湿性关节炎(RA)是一种慢性炎症性关节疾病,对生活质量有显著影响,在女性中尤为明显。先前的研究表明,口服避孕药(OC)的使用可能会影响患RA的风险,但早期荟萃分析的结果相互矛盾,因此需要纳入更多最新数据进行更新分析。我们通过检索截至2024年9月的MedLine(通过PubMed)、Scopus和Cochrane数据库,对关于OC使用与RA风险的观察性研究进行了系统综述和荟萃分析。我们的分析表明,目前或以前使用OC与RA风险在统计学上显著降低相关(比值比0.80,95%置信区间0.70 - 0.91)。相比之下,目前使用(比值比0.59,95%置信区间0.34 - 1.02)和过去使用(比值比0.83,95%置信区间0.69 - 1.01)的相关性不太明确,可能是由于研究之间存在大量异质性。累积荟萃分析显示,OC使用的保护作用有适度的时间趋势。这项荟萃分析支持目前或以前使用OC与RA发生之间的保护关联,突出了激素因素在RA发病机制中的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7537/12027927/3c9e86b7233d/jcm-14-02710-g001.jpg

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