Stephanie K A Wong, Lori B Tucker, Kristin Houghton, David A Cabral, Mercedes Chan, Kimberly A Morishita, Rae S M Yeung, Kiem Oen, Ciaran M Duffy, Roberta A Berard, Gaëlle Chédeville, Thomas Loughin, Jaime Guzman
{"title":"许多加拿大人的故事：祖先与幼年特发性关节炎类别和疾病严重程度的关系。","authors":"Stephanie K A Wong, Lori B Tucker, Kristin Houghton, David A Cabral, Mercedes Chan, Kimberly A Morishita, Rae S M Yeung, Kiem Oen, Ciaran M Duffy, Roberta A Berard, Gaëlle Chédeville, Thomas Loughin, Jaime Guzman","doi":"10.1002/acr2.70092","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess associations of ancestry with juvenile idiopathic arthritis (JIA) categories and clinical Juvenile Arthritis Disease Activity Scores (cJADAS10) at presentation to pediatric rheumatology care in a multicultural country with universal health care.</p><p><strong>Methods: </strong>Parents reported their child's ancestry in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) cohort. For each ancestry reported for ≥30 children, we compared JIA category distribution and median cJADAS10 scores among three groups: only that ancestry, with that and other ancestries, and without that ancestry. Chi-square, Fisher's exact, and Kruskal-Wallis tests compared the three groups and multivariable linear regression assessed factors associated with cJADAS10 scores.</p><p><strong>Results: </strong>Among 1,407 participants, 629 (44.7%) reported more than one ancestry. British ancestry was associated with higher median cJADAS10 scores (7.5) and higher frequency of enthesitis-related arthritis (18.7%) and psoriatic arthritis (10.0%), French ancestry was associated with lower cJADAS10 scores (5.8) and higher oligoarthritis (51.2%), Indigenous ancestry was associated with higher cJADAS10 scores (11.0) and higher rheumatoid factor-positive polyarthritis (21.9%), Black ancestry was associated with higher rheumatoid factor-positive polyarthritis (16.0%), and Eastern European ancestry was associated with lower cJADAS10 scores (3.6). Associations of ancestry with cJADAS10 scores were largely explained by differences in JIA categories (total R<sup>2</sup> = 0.28, with R<sup>2</sup> = 0.25 for JIA category alone). Black ancestry was associated with longer time from symptom onset to diagnosis (27 vs 18.9 weeks).</p><p><strong>Conclusions: </strong>British and French ancestries had distinct associations with JIA categories and cJADAS10 scores, and many children had multiple ancestries, questioning the use of a single \"European\" reference group. Higher cJADAS10 scores were largely explained by differences in JIA categories across ancestries.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 9","pages":"e70092"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399783/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Tale of Many Canadas: Associations of Ancestry With Juvenile Idiopathic Arthritis Categories and Disease Severity at Presentation to Care.\",\"authors\":\"Stephanie K A Wong, Lori B Tucker, Kristin Houghton, David A Cabral, Mercedes Chan, Kimberly A Morishita, Rae S M Yeung, Kiem Oen, Ciaran M Duffy, Roberta A Berard, Gaëlle Chédeville, Thomas Loughin, Jaime Guzman\",\"doi\":\"10.1002/acr2.70092\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess associations of ancestry with juvenile idiopathic arthritis (JIA) categories and clinical Juvenile Arthritis Disease Activity Scores (cJADAS10) at presentation to pediatric rheumatology care in a multicultural country with universal health care.</p><p><strong>Methods: </strong>Parents reported their child's ancestry in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) cohort. For each ancestry reported for ≥30 children, we compared JIA category distribution and median cJADAS10 scores among three groups: only that ancestry, with that and other ancestries, and without that ancestry. Chi-square, Fisher's exact, and Kruskal-Wallis tests compared the three groups and multivariable linear regression assessed factors associated with cJADAS10 scores.</p><p><strong>Results: </strong>Among 1,407 participants, 629 (44.7%) reported more than one ancestry. British ancestry was associated with higher median cJADAS10 scores (7.5) and higher frequency of enthesitis-related arthritis (18.7%) and psoriatic arthritis (10.0%), French ancestry was associated with lower cJADAS10 scores (5.8) and higher oligoarthritis (51.2%), Indigenous ancestry was associated with higher cJADAS10 scores (11.0) and higher rheumatoid factor-positive polyarthritis (21.9%), Black ancestry was associated with higher rheumatoid factor-positive polyarthritis (16.0%), and Eastern European ancestry was associated with lower cJADAS10 scores (3.6). Associations of ancestry with cJADAS10 scores were largely explained by differences in JIA categories (total R<sup>2</sup> = 0.28, with R<sup>2</sup> = 0.25 for JIA category alone). Black ancestry was associated with longer time from symptom onset to diagnosis (27 vs 18.9 weeks).</p><p><strong>Conclusions: </strong>British and French ancestries had distinct associations with JIA categories and cJADAS10 scores, and many children had multiple ancestries, questioning the use of a single \\\"European\\\" reference group. Higher cJADAS10 scores were largely explained by differences in JIA categories across ancestries.</p>\",\"PeriodicalId\":93845,\"journal\":{\"name\":\"ACR open rheumatology\",\"volume\":\"7 9\",\"pages\":\"e70092\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399783/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACR open rheumatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/acr2.70092\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACR open rheumatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/acr2.70092","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
A Tale of Many Canadas: Associations of Ancestry With Juvenile Idiopathic Arthritis Categories and Disease Severity at Presentation to Care.
Objective: To assess associations of ancestry with juvenile idiopathic arthritis (JIA) categories and clinical Juvenile Arthritis Disease Activity Scores (cJADAS10) at presentation to pediatric rheumatology care in a multicultural country with universal health care.
Methods: Parents reported their child's ancestry in the Research in Arthritis in Canadian Children Emphasizing Outcomes (ReACCh-Out) cohort. For each ancestry reported for ≥30 children, we compared JIA category distribution and median cJADAS10 scores among three groups: only that ancestry, with that and other ancestries, and without that ancestry. Chi-square, Fisher's exact, and Kruskal-Wallis tests compared the three groups and multivariable linear regression assessed factors associated with cJADAS10 scores.
Results: Among 1,407 participants, 629 (44.7%) reported more than one ancestry. British ancestry was associated with higher median cJADAS10 scores (7.5) and higher frequency of enthesitis-related arthritis (18.7%) and psoriatic arthritis (10.0%), French ancestry was associated with lower cJADAS10 scores (5.8) and higher oligoarthritis (51.2%), Indigenous ancestry was associated with higher cJADAS10 scores (11.0) and higher rheumatoid factor-positive polyarthritis (21.9%), Black ancestry was associated with higher rheumatoid factor-positive polyarthritis (16.0%), and Eastern European ancestry was associated with lower cJADAS10 scores (3.6). Associations of ancestry with cJADAS10 scores were largely explained by differences in JIA categories (total R2 = 0.28, with R2 = 0.25 for JIA category alone). Black ancestry was associated with longer time from symptom onset to diagnosis (27 vs 18.9 weeks).
Conclusions: British and French ancestries had distinct associations with JIA categories and cJADAS10 scores, and many children had multiple ancestries, questioning the use of a single "European" reference group. Higher cJADAS10 scores were largely explained by differences in JIA categories across ancestries.
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