Assessing whether the association between rheumatoid arthritis and schizophrenia is bidirectional: A nationwide population-based cohort study
Assessing whether the association between rheumatoid arthritis and schizophrenia is bidirectional: A nationwide population-based cohort study
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DOI：
10.1038/s41598-018-38149-3
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发表时间：
2019-03-14
影响因子：
4.6
通讯作者：
Shen, Yu-Chih
中科院分区：
文献类型：
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作者：
Chen, Shih-Fen;Wang, Ling-Yi;Shen, Yu-Chih
由于许多研究表明精神分裂症（SCZ）患者类风湿性关节炎（RA）的发病率降低，因此很少有人致力于研究亚洲人群中的这种联系。此外，这两种疾病之间的关系可能是双向的，但RA对SCZ发病率的影响尚不清楚。该研究旨在确定在亚洲人群中RA和SCZ之间是否存在双向关联。我们使用台湾全民健康保险研究资料库分析一个10年的以人口为基础的纵向队列.在第一次分析中，我们共纳入了58，847名SCZ患者和235，382名非SCZ对照，在第二次分析中，共纳入了30，487名RA患者和121，833名非RA对照，两者均按性别、年龄和索引日期匹配。进行了考克斯回归分析，以检查第一次分析中RA发病率的风险和第二次分析中SCZ发病率的风险。本研究的主要发现是，在校正基线人口统计学和合并症后，发现SCZ患者的RA发生率较低（风险比（HR）：0.48，95%置信区间（95%CI）：0.31-0.77）。此外，RA的存在预测SCZ的发生率降低，但估计值无统计学显著性（HR：0.77，95% CI：0.44-1.37）。该研究发现RA和SCZ之间存在单向关联。但是，RA的发病年龄晚于RA，并且由于病例数量有限，RA对SCZ发病率的保护作用可能存在偏差。
Since many studies have shown a reduction in the incidence of rheumatoid arthritis (RA) in patients with schizophrenia (SCZ), little effort has been devoted to studying this link in the Asian population. Moreover, the relationship between these two disorders could be bidirectional, but the influence of RA on the SCZ incidence is unclear. The study aims to determine whether there is a bidirectional association between RA and SCZ in an Asian population. We analyzed a 10-year population- based longitudinal cohort using the National Health Insurance Research Database of Taiwan. In the first analysis, we included a total of 58,847 SCZ patients and 235, 382 non-SCZ controls, and in the second analysis, a total of 30,487 RA patients and 121,833 non-RA controls, both matched by gender, age, and index date. Cox regression analyses were performed to examine the risk of RA incidence in the first analysis and the risk of SCZ incidence in the second analysis. The main finding of this study was the discovery of a lower incidence of RA in patients with SCZ (hazard ratio (HR): 0.48, 95% confidence interval (95%Cl): 0.31-0.77) after adjustment for baseline demographics and comorbidities. Additionally, the presence of RA predicted a reduced incidence rate for SCZ, but the estimate was not statistically significant (HR: 0.77, 95% CI: 0.44-1.37). The study found a unidirectional association between RA and SCZ. However, RA has an age of onset later than RA, and the protective effect of RA on SCZ incidence would be biased due to the limited number of cases.