炎症性肠病患者一级亲属和配偶中的脊柱关节炎:一项基于瑞典全国人口的队列研究。

Sarita Shrestha, Judith S Brand, Mehdi Osooli, Carl Eriksson, Ida Schoultz, Johan Askling, Tine Jess, Scott Montgomery, Ola Olén, Jonas Halfvarson
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引用次数: 0

摘要

背景和目的:基于登记的研究表明,炎症性肠病[IBD]和脊柱关节炎[SpA]之间存在共同的病理生理学,但家族[遗传和环境]因素在这种共同易感性中所起的作用在很大程度上是未知的。我们比较了 IBD 患者的一级亲属(FDRs)及其配偶与匹配人群参照个体的一级亲属及其配偶患 SpA 的风险:通过将瑞典全国范围内的登记和胃肠道活检数据联系起来,我们确定了 2006-2016 年间 147,080 名 IBD 患者的一级亲属和 25,945 名配偶[N=39,203],以及 1,453,429 名一级亲属和 258,098 名匹配参照个体的配偶[N=390,490]。研究参与者的随访时间为 1987 年至 2017 年。采用 Cox 回归估算 SpA 的危险比 [HRs]:在随访期间,有 2430 名 IBD 患者(6.5/10,000 人-年)和 17761 名参照者(4.8/10,000 人-年)被诊断为 SpA,HR 值为 1.35 [95%CI:1.29,1.41]。在亚组分析中,克罗恩病患者[HR=1.44;95%CI:1.34,1.56]和结论年龄段的 IBD 患者的 FDRs 患 SpA 的风险增加最为明显:所观察到的 IBD 和 SpA 之间的共同家族风险支持这两种疾病发病机制中存在共同的遗传因素。然而,IBD 患者的配偶患 SpA 的风险也增加了,这反映了环境暴露的影响或寻求健康模式的相似性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spondyloarthritis in First-Degree Relatives and Spouses of Patients with Inflammatory Bowel Disease: A Nationwide Population-based Cohort Study from Sweden.

Background and aims: Register-based research suggests a shared pathophysiology between inflammatory bowel disease [IBD] and spondyloarthritis [SpA], but the role of familial [genetic and environmental] factors in this shared susceptibility is largely unknown. We aimed to compare the risk of SpA in first-degree relatives [FDRs] and spouses of IBD patients with FDRs and spouses of matched, population-based, reference individuals.

Methods: We identified 147 080 FDRs and 25 945 spouses of patients with incident IBD [N = 39 203] during 2006-2016, and 1 453 429 FDRs and 258 098 spouses of matched reference individuals [N = 390 490], by linking nationwide Swedish registers and gastrointestinal biopsy data. Study participants were followed 1987-2017. Cox regression was used to estimate hazard ratios [HRs] of SpA.

Results: During follow-up, 2430 FDRs of IBD patients [6.5/10 000 person-years] and 17 761 FDRs of reference individuals [4.8/10 000 person-years] were diagnosed with SpA, corresponding to an HR of 1.35 [95% CI:1.29, 1.41]. In subgroup analyses, the increased risk of SpA was most pronounced in FDRs of Crohn's disease patients [HR = 1.44; 95% CI:1.34,1.5 6] and of IBD patients aged <18 years at diagnosis [HR = 1.46; 95% CI: 1.27, 1.68]. IBD patients' spouses also had a higher SpA rate than reference individuals' spouses, but the difference was less pronounced [4.3 vs 3.5/10 000 person-years; HR = 1.22; 95% CI:1.09, 1.37]. No subgroup-specific risk pattern was identified among spouses.

Conclusions: The observed shared familial risks between IBD and SpA support shared genetic factors in their pathogenesis. However, spouses of IBD patients were also at increased risk for SpA, reflecting the influence of environmental exposures or similarities in health-seeking patterns.

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