Duhaut P, Pinede L, Demolombe-Rague S, Loire R, Seydoux D, Ninet J, Pasquier J
Edouard Herriot Hospital, Lyon, France.
Arthritis Rheum. 1998 Nov;41(11):1960-5. doi: 10.1002/1529-0131(199811)41:11<1960::AID-ART10>3.0.CO;2-X.
To assess the role of cardiovascular risk factors, measured at the time of diagnosis, in the pathogenesis of giant cell (temporal) arteritis (GCA).
Four hundred new patients with GCA or polymyalgia rheumatica (PMR) and population-based, individually age- and sex-matched controls were included in this multicenter, prospective case-control study. Each participant was evaluated by review of the medical history and by clinical and laboratory assessments.
Among women, smoking was associated with a 6-fold increase in risk (P = 0.00006, 95% confidence interval [95% CI] 2-17), heavy smoking with a 17-fold increase in risk, and previous atheromatous disease with a 4.5-fold increase in risk (P = 0.0003, 95% CI 2-11) of GCA in both the biopsy-positive and biopsy-negative GCA groups; only smoking appeared to be a risk factor for PMR in women (odds ratio 3.64, 95% CI 1.07-12.40). Among men, no risk factor was found to be significant.
Smoking and previous arterial disease were independently associated with GCA in women. In order to avoid matching bias, risk factors for diseases with an unbalanced sex distribution should be studied separately in each sex, using a sex-matched, case-control study design.
评估诊断时所测心血管危险因素在巨细胞（颞）动脉炎（GCA）发病机制中的作用。
本多中心前瞻性病例对照研究纳入了400例新诊断的GCA或风湿性多肌痛（PMR）患者以及基于人群、年龄和性别匹配的个体对照。通过病史回顾、临床和实验室评估对每位参与者进行评估。
在女性中，吸烟使GCA风险增加6倍（P = 0.00006，95%置信区间[95%CI]2 - 17），重度吸烟使风险增加17倍，既往动脉粥样硬化疾病使活检阳性和活检阴性GCA组的GCA风险增加4.5倍（P = 0.0003，95%CI 2 - 11）；仅吸烟似乎是女性PMR的危险因素（比值比3.64，95%CI 1.07 - 12.40）。在男性中，未发现有显著的危险因素。
吸烟和既往动脉疾病与女性GCA独立相关。为避免匹配偏倚，对于性别分布不均衡疾病的危险因素，应采用性别匹配的病例对照研究设计，按性别分别进行研究。
