Cardiovascular risk factors and incident giant cell arteritis: a population-based cohort study
Cardiovascular risk factors and incident giant cell arteritis: a population-based cohort study
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DOI：
10.1080/03009742.2018.1506821
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发表时间：
2019-05-04
影响因子：
2.1
通讯作者：
Merkel, P. A.
中科院分区：
文献类型：
--
作者：
Tomasson, G.;Bjornsson, J.;Merkel, P. A.
目的：评估一般人群中心血管危险因素对巨细胞动脉炎（GCA）发病率的影响强度。方法：使用雷克雅未克研究（RS）的数据，这是一项以人群为基础的队列研究，重点关注心血管疾病。1967年12月1日，所有出生于1907-1935年、居住在冰岛雷克雅未克或邻近社区的人都被邀请参加。受试者参加了1967-1996年的研究访问，并获得了心血管风险因素[吸烟习惯，血压，糖尿病，体重指数（BMI）和血清胆固醇]的信息。由一名具有血管病理学专业知识的病理学家重新检查从RS队列成员中获得的所有颞动脉活检。风险因素对GCA发生的影响表示为发病率比（IRR）和95%置信区间（CI）。结果：总共有19241名受试者在50岁后的中位数为23.1（四分位距17.6-29.4）年。在444 126人-年的随访期间，194例受试者发生GCA，对应的发生率为43.6（95% CI 37.8-50.2）/100 000人-年。超重或肥胖与GCA呈负相关，尤其是在女性中[IRR分别为0.70（0.48-1.02）和0.31（0.14-0.71）]。在男性中，BMI和GCA事件之间的关联较弱。吸烟与男性GCA呈负相关[IRR 0.47（0.27-0.81）]，但在女性中不相关。结论：GCA在冰岛的发病率很高。高BMI可以预防GCA的发生，吸烟可以预防男性GCA。
Objective: To assess the strength of the effect of cardiovascular risk factors on the incidence of giant cell arteritis (GCA) in a general population context. Method: Data from the Reykjavik Study (RS), a population-based cohort study focusing on cardiovascular disease, were used. Everyone born in 1907-1935 living in Reykjavik, Iceland, or adjacent communities on 1 December 1967 were invited to participate. Subjects attended a study visit in 1967-1996 and information on cardiovascular risk factors [smoking habits, blood pressure, diabetes, body mass index (BMI), and serum cholesterol] was obtained. All temporal artery biopsies obtained from members of the RS cohort were re-examined by a single pathologist with expertise in vascular pathology. Effects of risk factors on GCA occurrence are expressed as incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Results: Altogether, 19 241 subjects contributed a median of 23.1 (interquartile range 17.6-29.4) years after the age of 50 to this analysis. During 444 126 person-years of follow-up, 194 subjects developed GCA, corresponding to an incidence rate of 43.6 (95% CI 37.8-50.2) per 100 000 person-years. Being overweight or obese were inversely associated with GCA, especially in women [IRRs 0.70 (0.48-1.02) and 0.31 (0.14-0.71), respectively]. There was a weaker association between BMI and incident GCA in men. Smoking was inversely associated with GCA in men [IRR 0.47 (0.27-0.81)], but not in women. Conclusions: The incidence of GCA in Iceland is very high. High BMI protects against the occurrence of GCA, and smoking may protect against GCA in men.