腕管综合征(Carpal Tunnel Syndrome, CTS)是类风湿关节炎(RA)的早期未被充分认识的特征:一项基于人群的RA发病前后CTS发生的研究

IF 3.3 2区 医学 Q1 RHEUMATOLOGY
Roslin Jose George, Noah Frechette, Manuela Oviedo, Iqra Javed, Sara J Achenbach, Ryan J Lennon, Bradley Alex Kimbrough, Elena K Joerns, Vanessa L Kronzer, Anne Gingery, John M Davis, Cynthia S Crowson, Elena Myasoedova
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引用次数: 0

摘要

目的:研究类风湿关节炎(RA)发病前后腕管综合征(CTS)的血清学状况。方法:这项基于人群的研究纳入了1980-2019年符合1987年ACR RA分类标准的地理定义区域的居民,与非RA个体进行1:1匹配。至少使用两个间隔≥30天的诊断代码来识别CTS。评估经竞争死亡风险调整后的CTS累积发生率。采用Logistic回归和Cox比例风险模型,调整了年龄、性别、日历年、吸烟、肥胖、糖尿病和甲状腺功能减退等因素。结果:我们纳入1335例RA患者和1331例非RA患者。在RA发病/指数之前或之后,CTS的总体患病率分别为179(13%)和85 (6%):or为2.23;95% ci 1.69-2.94。大多数CTS的既往发病率发生在索引日期前≥2年(分别为112例和75例)。根据RA发病率/指数,RA患者(与非RA患者相比)发生CTS的风险高出约80% (HR 1.78;95%可信区间1.38 - -2.30)。血清阴性(与血清阳性)RA患者发生CTS的风险估计OR为1.33;RA发病前95%CI 0.96-1.84, RA发病后HR: 1.37, 95%CI 0.99-1.88。在RA中,肥胖(HR 1.42, 95% CI 1.02-1.99)和血清ccp抗体阴性状态(HR 1.79, 95% CI 1.07-2.99)与CTS风险增加相关,但与其他危险因素无关。结论:我们发现,在RA发病前几年,CTS的风险增加了2倍以上,RA发病后发生CTS的风险增加了1.8倍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Carpal Tunnel Syndrome as an Early Underrecognized Feature of Rheumatoid Arthritis: A Population-Based Study of Carpal Tunnel Syndrome Occurrence Before and After Rheumatoid Arthritis Incidence.

Objective: We aimed to assess the occurrence of carpal tunnel syndrome (CTS) before and after rheumatoid arthritis (RA) incidence and by serologic status.

Methods: This population-based study included residents of a geographically defined area meeting the 1987 American College of Rheumatology classification criteria for RA in 1980 to 2019 matched 1:1 with individuals without RA. At least two diagnosis codes ≥30 days apart were used to identify CTS. Cumulative incidence of CTS adjusting for competing risk of death was assessed. Logistic regression and Cox proportional hazard models were used, adjusting for age, sex, calendar year, smoking, obesity, diabetes mellitus, and hypothyroidism.

Results: We included 1,335 patients with RA and 1,331 individuals without RA. The overall prevalence of CTS before or on RA incidence or index was 179 patients with RA (13%) and 85 individuals without RA (6%), respectively (odds ratio [OR] 2.23; 95% confidence interval [CI] 1.69-2.94). Most previous incidences of CTS occurred ≥2 years before the index date (112 events in patients with RA and 75 events in individuals without RA, respectively). Following RA incidence or index, individuals with RA (vs those without RA) had ~80%-higher risk of CTS (hazard ratio [HR] 1.78; 95% CI 1.38-2.30). The risk estimates of CTS in patients with seronegative (vs seropositive) RA were OR 1.33 (95% CI 0.96-1.84) before RA incidence and HR 1.37 (95% CI 0.99-1.88) after RA incidence. In RA, obesity (HR 1.42, 95% CI 1.02-1.99) and seronegative cyclic citrullinated peptide antibody status (HR 1.79, 95% CI 1.07-2.99), but not other risk factors, were associated with increased CTS risk.

Conclusion: We found a more than two-fold increase in risk of CTS in the years preceding RA and a 1.8-fold increased risk of incident CTS following RA onset.

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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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