性别、血清状态和吸烟对类风湿关节炎相关间质性肺病亚型风险的影响

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Gregory C McDermott, Keigo Hayashi, Pierre‐Antoine Juge, Ritu Gill, Suzanne Byrne, Staci Gagne, Xiaosong Wang, Misti L Paudel, Matthew Moll, Michael H Cho, Kathleen Vanni, Emily Kowalski, Grace Qian, Katarina Bade, Alene Saavedra, Yumeko Kawano, Michael DiIorio, Taylor Wolfgang, Edy Y Kim, Paul F Dellaripa, Michael E Weinblatt, Nancy Shadick, Tracy J Doyle, Jeffrey A Sparks
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We determined RA‐ILD subtype (usual interstitial pneumonia [UIP], nonspecific interstitial pneumonia [NSIP], and other/indeterminate) through chest high‐resolution computed tomography imaging pattern. We investigated associations between demographic, lifestyle, and serologic factors and major RA‐ILD subtypes using multivariable logistic regression.ResultsAmong 3328 RA patients, we identified 208 RA‐ILD cases and 547 RA‐noILD controls. RA‐UIP was associated with older age (OR 1.03 per year, 95%CI 1.01 to 1.05), male sex (OR 2.15, 95%CI 1.33 to 3.48), and seropositivity (OR 2.08 95%CI 1.24 to 3.48) while RA‐NSIP was significantly associated only with seropositive status (OR 3.21, 95%CI 1.36 to 7.56). Non‐fibrotic ILDs were significantly associated with smoking (OR 2.81, 95%CI 1.52 to 5.21). 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引用次数: 0

摘要

目标RA相关性间质性肺病(RA-ILD)包括多种亚型,其组织病理学、预后和潜在治疗方法各不相同。对不同 RA-ILD 亚型风险因素的研究有限。因此,我们研究了人口统计学、血清学和生活方式与 RA-ILD 亚型的关联。方法我们在布里格姆 RA 序列研究(Brigham RA Sequential Study)和麻省总医院布里格姆生物库 RA 队列中系统地识别了 RA-ILD 病例和 RA-noILD 对照。我们通过胸部高分辨率计算机断层扫描成像图确定了 RA-ILD 亚型(寻常间质性肺炎 [UIP]、非特异性间质性肺炎 [NSIP] 和其他/不确定)。结果在 3328 名 RA 患者中,我们发现了 208 例 RA-ILD 病例和 547 例 RA-noILD 对照。RA-UIP 与年龄较大(OR 值为每年 1.03,95%CI 为 1.01 至 1.05)、男性(OR 值为 2.15,95%CI 为 1.33 至 3.48)和血清阳性(OR 值为 2.08,95%CI 为 1.24 至 3.48)有关,而 RA-NSIP 仅与血清阳性状态显著相关(OR 值为 3.21,95%CI 为 1.36 至 7.56)。非纤维化性 ILD 与吸烟密切相关(OR 2.81,95%CI 1.52 至 5.21)。与无 RA-ILD 风险因素相比,具有三个 RA-ILD 风险因素(男性、血清阳性、吸烟)的 RA-UIP OR 为 6.89(96%CI 2.41 至 19.7)。结论年龄较大、血清阳性和男性性别与 RA-UIP 密切相关,而 RA 相关自身抗体与 RA-NSIP 相关。这些研究结果表明,RA-ILD 的性别差异可能是由 RA-UIP 驱动的,并强调了进一步研究以明确 RA-ILD 异质性并优化筛查和治疗方法的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of sex, serostatus, and smoking on risk for rheumatoid arthritis‐associated interstitial lung disease subtypes
ObjectivesRA‐associated interstitial lung disease (RA‐ILD) includes multiple subtypes with varying histopathology, prognosis, and potential treatments. Limited research has investigated risk factors for different RA‐ILD subtypes. Therefore, we examined demographic, serologic, and lifestyle associations with RA‐ILD subtypes.MethodsWe systematically identified RA‐ILD cases and RA‐noILD controls in the Brigham RA Sequential Study and Mass General Brigham Biobank RA cohort. We determined RA‐ILD subtype (usual interstitial pneumonia [UIP], nonspecific interstitial pneumonia [NSIP], and other/indeterminate) through chest high‐resolution computed tomography imaging pattern. We investigated associations between demographic, lifestyle, and serologic factors and major RA‐ILD subtypes using multivariable logistic regression.ResultsAmong 3328 RA patients, we identified 208 RA‐ILD cases and 547 RA‐noILD controls. RA‐UIP was associated with older age (OR 1.03 per year, 95%CI 1.01 to 1.05), male sex (OR 2.15, 95%CI 1.33 to 3.48), and seropositivity (OR 2.08 95%CI 1.24 to 3.48) while RA‐NSIP was significantly associated only with seropositive status (OR 3.21, 95%CI 1.36 to 7.56). Non‐fibrotic ILDs were significantly associated with smoking (OR 2.81, 95%CI 1.52 to 5.21). Having three RA‐ILD risk factors (male, seropositive, smoking) had an OR of 6.89 (96%CI 2.41 to 19.7) for RA‐UIP compared to having no RA‐ILD risk factors.ConclusionsOlder age, seropositivity, and male sex were strongly associated with RA‐UIP while RA‐related autoantibodies were associated with RA‐NSIP. These findings suggest RA‐ILD sex differences may be driven by RA‐UIP and emphasizes the importance of further studies to clarify RA‐ILD heterogeneity and optimize screening and treatment approaches.
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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