解开吸烟与全身性硬化症之间的关系:对EUSTAR队列的分析
Jacopo Ciaffi1,2, Sophie I E Liem3, Suzanne Cannegieter4,5
1Medicine and Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy jacopo.ciaffi@ior.it.
RMD open
|May 21, 2024
概括
吸烟增加了男性全身性硬化症 (SSc) 患者的死亡风险,并且与那些具有抗毒素酶 (ATA) 或抗中心酶 (ACA) 抗体的患者的死亡结果更差有关. 然而,吸烟与较低的ATA患病率有关,特别是在女性中.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 系统性硬化症 (SSc) 是一种具有显著发病率和死亡率的自身免疫性疾病.
- 吸烟对SSc发展和进展的影响仍然不完全理解.
- 了解吸烟的作用对于管理SSc及其并发症至关重要.
研究的目的:
- 调查吸烟与全身性硬化症 (SSc) 之间的关联.
- 分析吸烟对SSc患者自身抗体状态,疾病进展和死亡率的影响.
- 根据性别和特定的自身抗体 (ACA,ATA) 分层发现.
主要方法:
- 分析欧洲硬质皮炎试验和研究队列 (12,314名患者).
- 经常吸烟者与从未吸烟者之间自身抗体状况的比较.
- 使用卡普兰-梅尔曲线和考克斯模型在15年内评估疾病进展的时间.
- 按性别分层分析和抗中心体 (ACA) 和抗毒素酶 (ATA) 抗体的阳性.
主要成果:
- 吸烟与男性SSc患者的死亡率增加有关 (HR 1.63).
- 长期吸烟的女性患皮肤病变 (HR 1.10) 和任何器官病变 (HR 1.07) 的风险更高.
- 吸烟与女性的ATA发病率较低 (34%对21%) 相关,并减少了ATA频率与更高的包装年/持续时间.
- 在ACA阳性患者中,吸烟增加了死亡风险,心脏参与,皮肤和任何器官进展.
- 在ATA阳性吸烟者中,死亡率,皮肤进展,数字以及任何器官进展都更频繁.
结论:
- 吸烟增加了男性SSc患者的死亡风险.
- 吸烟与较低的ATA患病率有关,特别是在女性中.
- 在ACA和ATA阳性SSc患者中,吸烟是死亡率和器官进展的重要风险因素.
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