Extrahepatic Autoimmune Diseases are Prevalent in Autoimmune Hepatitis Patients and Their First-Degree Relatives: Survey Study.
Extrahepatic Autoimmune Diseases are Prevalent in Autoimmune Hepatitis Patients and Their First-Degree Relatives: Survey Study.
复制标题
DOI：
10.2196/ijmr.9625
复制
发表时间：
2018-12-19
影响因子：
2
通讯作者：
Lammert, Craig
中科院分区：
文献类型：
--
作者：
Fogel, Rachel;Comerford, Megan;Lammert, Craig
背景：自身免疫性肝炎并发疾病增加了自身免疫性肝炎患者的医疗负担，降低了患者的生活质量。北美AIH患者及其家人共存自身免疫性疾病的频率仍不完整。与电子病历中的疾病捕获相关的挑战，高昂的研究成本，以及患者的地理分布是了解这些群体并发自身免疫疾病程度的巨大障碍。目的：本研究的目的是调查AIH患者和健康对照及其使用社交网站(SNS)的一级亲属中肝外自身免疫性疾病(EHAD)的频率。方法：我们开发了一份包含53个问题的调查，详细描述了自身免疫性疾病的历史。在SNS上的特定网络队列中，定期发布调查链接。没有自我报告的自身免疫性肝病的健康对照组是从亚马逊的机械土耳其人那里招募的。用Wilcoxon秩和检验获得的中位数和P值对连续变量进行总结。结果：与对照组(n=1162)相比，病例组(n=306)年龄更大(中位年龄：49比33岁)，女性(284/306，92.81%比955/1162，82.18%)，有高血压(128/306，41.83%比218/1162，18.76%；P=.001)。最常见的EHADs是甲状腺疾病(49/306，16.01%)、干燥综合征(27/306，8.82%)、雷诺现象(23/306，7.52%)、银屑病(22/306，7.19%)。总体而言，55.88%(171/306)的病例和35.71%(1601/4484)的对照报告至少有一名一级亲属(FDR)有EHAD病史(P=.001)。在调整了年龄、性别、种族和体重指数后，AIH患者合并EHAD的风险显著高于对照组：优势比为2.46(95%可信区间为1.8~3.3)；P=0.001。结论：AIH患者合并EHAD的患病率高于健康对照组，他们的FDR也更有可能患有自身免疫性疾病。
BACKGROUND: Concurrent autoimmune illnesses contribute to increased medical burden and reduced quality of life in patients with autoimmune hepatitis (AIH). The frequency of coexisting autoimmune conditions among North American patients with AIH and their families remains incomplete. Challenges associated with disease capture in the electronic medical record, high study costs, and geographic spread of patients are formidable barriers to understanding the extent of concurrent autoimmune conditions in these groups.OBJECTIVE: This objective of this study was to examine the frequency of extrahepatic autoimmune diseases (EHAD) among AIH cases and healthy controls as well as their first-degree relatives using social networking sites (SNS).METHODS: We developed a 53-question survey detailing the history of autoimmune diseases. A survey link was posted at routine intervals within specific Web-based cohorts on SNS. Healthy controls, without self-reported autoimmune liver disease, were recruited from Amazon's Mechanical Turk. Continuous variables were summarized using medians and P values obtained with the Wilcoxon rank-sum test. Categorical variables were compared using the chi-square test.RESULTS: Compared with controls (n=1162), cases (n=306) were more likely to be older (median age: 49 vs 33 years), female (284/306, 92.81% vs 955/1162, 82.18%), and have an EHAD (128/306, 41.83% vs 218/1162, 18.76%; P=.001). The most frequent EHADs among cases were thyroid disease (49/306, 16.01% ), Sjogren syndrome (27/306, 8.82%), Raynaud phenomenon (23/306, 7.52%), and psoriasis (22/306, 7.19%). Overall, 55.88% (171/306) of cases and 35.71% (1601/4484) of controls reported at least 1 first-degree relative (FDR) with a history of EHAD (P=.001). Cases had a significantly higher risk of EHAD than controls after the adjustment for age, sex, race, and body mass index: odds ratio 2.46 (95% CI 1.8-3.3); P=.001.CONCLUSIONS: Patients with AIH report higher prevalence of coexistent EHAD than healthy controls, and their FDRs are also more likely to have autoimmune disorders.