Ming-Ling Chang, Jur-Shan Cheng, Puo-Hsien Le, Wei-Ting Chen, Hsin-Ping Ku, Rong-Nan Chien
{"title":"台湾抗线粒体抗体阳性与原发性胆汁性胆管炎的演变关系：一项为期 16 年的医院队列研究。","authors":"Ming-Ling Chang, Jur-Shan Cheng, Puo-Hsien Le, Wei-Ting Chen, Hsin-Ping Ku, Rong-Nan Chien","doi":"10.1177/17562848241241227","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown.</p><p><strong>Objectives: </strong>We aimed to investigate this evolution in Taiwan.</p><p><strong>Design/methods: </strong>A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.</p><p><strong>Results: </strong>AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/10<sup>5</sup> <i>versus</i> 11.61/10<sup>5</sup>, <i>p</i> = 0.0002), but their incidence was comparable (0.99/10<sup>5</sup> <i>versus</i> 1.12/10<sup>5</sup>, <i>p</i> = 0.36). The former group had a borderline significantly lower mean age (56.59 years <i>versus</i> 58.10 years, <i>p</i> = 0.06) and a lower female-to-male ratio (2.85:1 <i>versus</i> 5.44:1, <i>p</i> < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, <i>p</i> < 0.01; incidence change: -9.2%, <i>p</i> < 0.01) and PBC patients (prevalence change: 14.6%, <i>p</i> < 0.01; incidence change: -4.7%, <i>p</i> <i><</i> 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% <i>versus</i> 4.3%, <i>p</i> = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% <i>versus</i> 15.60%, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981211/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evolutionary relationship between antimitochondrial antibody positivity and primary biliary cholangitis in Taiwan: a 16-year hospital cohort study.\",\"authors\":\"Ming-Ling Chang, Jur-Shan Cheng, Puo-Hsien Le, Wei-Ting Chen, Hsin-Ping Ku, Rong-Nan Chien\",\"doi\":\"10.1177/17562848241241227\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown.</p><p><strong>Objectives: </strong>We aimed to investigate this evolution in Taiwan.</p><p><strong>Design/methods: </strong>A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.</p><p><strong>Results: </strong>AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/10<sup>5</sup> <i>versus</i> 11.61/10<sup>5</sup>, <i>p</i> = 0.0002), but their incidence was comparable (0.99/10<sup>5</sup> <i>versus</i> 1.12/10<sup>5</sup>, <i>p</i> = 0.36). The former group had a borderline significantly lower mean age (56.59 years <i>versus</i> 58.10 years, <i>p</i> = 0.06) and a lower female-to-male ratio (2.85:1 <i>versus</i> 5.44:1, <i>p</i> < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, <i>p</i> < 0.01; incidence change: -9.2%, <i>p</i> < 0.01) and PBC patients (prevalence change: 14.6%, <i>p</i> < 0.01; incidence change: -4.7%, <i>p</i> <i><</i> 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% <i>versus</i> 4.3%, <i>p</i> = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% <i>versus</i> 15.60%, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981211/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848241241227\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848241241227","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
背景：在病毒性肝炎流行地区，抗线粒体抗体（AMA）阳性患者是如何演变为原发性胆汁性胆管炎的？在病毒性肝炎流行地区，抗线粒体抗体（AMA）阳性患者如何演变为原发性胆汁性胆管炎（PBC）尚不清楚：设计/方法：一项为期 16 年、以医疗中心为基础的队列研究：我们在病毒性肝炎流行的亚洲国家台湾开展了一项为期 16 年、以医疗中心为基础的队列研究，共纳入 2,095,628 名受试者。AMA阳性受试者是指AMA阳性且碱性磷酸酶（ALP）⩽1.5倍于正常值上限（ULN）的受试者，PBC是指AMA阳性且ALP >1.5 × ULN的受试者：经年龄和性别调整后，AMA 阳性受试者的平均患病率低于 PBC 患者（4.68/105 对 11.61/105，p = 0.0002），但两者的发病率相当（0.99/105 对 1.12/105，p = 0.36）。前者的平均年龄略低（56.59 岁对 58.10 岁，p = 0.06），男女比例较低（2.85:1 对 5.44:1，p p p p 0.01），患病率有所上升，但发病率有所下降。在 423 名 AMA 阳性受试者中，有 77 人（18.2%）发展为 PBC，平均病程为 1.757 年。与 AMA 阳性受试者相比，PBC 患者的慢性乙型肝炎（CHB）并发率相似（2.7% 对 4.3%，P = 0.197），但慢性丙型肝炎（CHC）并发率较低（3.69% 对 15.60%，P 结论：PBC 的发病率高于 AMA 阳性受试者：PBC的发病率高于AMA阳性受试者，PBC患者的男女比例高于AMA阳性受试者，其中18.2%的患者发展为PBC（平均滞后时间：1.757年）。AMA阳性受试者和PBC的患病率呈上升趋势，发病率呈下降趋势。CHB很少见，CHC在PBC患者中的发病率高于普通人群，而CHC在PBC患者中的发病率低于AMA阳性受试者。
Evolutionary relationship between antimitochondrial antibody positivity and primary biliary cholangitis in Taiwan: a 16-year hospital cohort study.
Background: How antimitochondrial antibody (AMA)-positive patients evolve to have primary biliary cholangitis (PBC) in viral hepatitis-endemic areas is unknown.
Objectives: We aimed to investigate this evolution in Taiwan.
Design/methods: A 16-year medical center-based cohort study of 2,095,628 subjects was conducted in Taiwan, an Asian country endemic to viral hepatitis. AMA-positive subjects were those with positive AMA with alkaline phosphatase (ALP) ⩽1.5 times the upper limit of normal (ULN), and PBC was defined as positive AMA with ALP >1.5 × ULN.
Results: AMA-positive subjects had a lower average age- and sex-adjusted prevalence than PBC patients (4.68/105versus 11.61/105, p = 0.0002), but their incidence was comparable (0.99/105versus 1.12/105, p = 0.36). The former group had a borderline significantly lower mean age (56.59 years versus 58.10 years, p = 0.06) and a lower female-to-male ratio (2.85:1 versus 5.44:1, p < 0.0001). Both AMA-positive subjects (prevalence change: 20.0%, p < 0.01; incidence change: -9.2%, p < 0.01) and PBC patients (prevalence change: 14.6%, p < 0.01; incidence change: -4.7%, p< 0.01) prevalence rate increased but the incidence rate decreased. Among the 423 AMA-positive subjects, 77 (18.2%) developed PBC, for a mean duration of 1.757 years. Compared with AMA-positive subjects, PBC patients had similar concurrent chronic hepatitis B (CHB) rates (2.7% versus 4.3%, p = 0.197) but lower chronic hepatitis C (CHC) rates (3.69% versus 15.60%, p < 0.01).
Conclusion: PBC was more prevalent than AMA-positive subjects, and PBC patients had a higher female-to-male ratio than AMA-positive subjects, of whom 18.2% developed PBC (mean lag: 1.757 years). Upward trends in prevalence rates and downward trends in incidence rates were noted for both AMA-positive subjects and PBC. CHB was rare, CHC was more prevalent among PBC patients than the general population, and CHC was less prevalent among PBC than among AMA-positive subjects.
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