A Metaanalysis of the Increased Risk of Rheumatoid Arthritis-related Pulmonary Disease as a Result of Serum Anticitrullinated Protein Antibody Positivity
A Metaanalysis of the Increased Risk of Rheumatoid Arthritis-related Pulmonary Disease as a Result of Serum Anticitrullinated Protein Antibody Positivity
复制标题
血清抗瓜氨酸蛋白抗体阳性导致类风湿性关节炎相关肺部疾病风险增加的荟萃分析
DOI：
10.3899/jrheum.131341
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发表时间：
2014-07-01
影响因子：
3.9
通讯作者：
Li, Juan
中科院分区：
文献类型：
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作者：
Zhu, Junqing;Zhou, Yi;Li, Juan
Objective.血清抗瓜氨酸蛋白抗体（ACPA）水平与类风湿性关节炎（RA）相关肺部疾病风险之间存在不一致的相关性。在PubMed、ScienceDirect和SpringerLink数据库中对截至2013年8月发表的研究进行了电子检索。从符合条件的研究中获得病例和对照组血清ACPA水平的分布。通过OR和95%CI估计与血清ACPA阳性相关的RA相关肺部疾病的风险。根据异质性结果，采用固定效应模型或随机效应模型计算合并OR。进行发表偏倚和敏感性分析。总体而言，243例RA相关肺部疾病患者和1442例RA对照纳入荟萃分析。结果显示，血清ACPA阳性增加RA相关肺部疾病风险的合并OR为2.621（95% CI，1.561-4.403，p < 0.001）。在白色人群亚组中，增加的OR为3.453（95%CI 1.798-6.630，p < 0.001），而在亚洲人群亚组中未发现相关性。此外，我们进一步发现，血清ACPA阳性表明RA患者发生间质性肺疾病（ILD）和间质性肺纤维化（IPF）的风险更高（OR 4.679，95% CI 2.071-10.572，p < 0.001）。异质性、发表偏倚和敏感性分析在任何组中均无统计学意义。据我们所知。这是首次荟萃分析揭示血清ACPA阳性与RA相关肺部疾病的风险高度相关，特别是在RA相关ILD和IPF中。
Objective. An inconsistent association has been reported between the serum anticitrullinated protein antibodies (ACPA) level and rheumatoid arthritis (RA)-related pulmonary disease risk We conducted a metaanalysis to reveal the association between them.Methods. An electronic search was performed in PubMed, ScienceDirect, and SpringerLink databases for studies published up to August 2013. The distributions of the serum ACPA level in cases and controls were obtained from eligible studies. The risk of RA-related pulmonary disease associated with serum ACPA positivity was estimated by OR and 95% CI. According to the heterogeneity results, a fixed-effects model or a random-effects model was used to calculate the pooled OR. Publication bias and sensitivity analyses were conducted.Results. Overall, 243 patients with RA-related pulmonary disease and 1442 RA controls were included in the metaanalysis. The results showed that the pooled OR was 2.621 (95% CI, 1.561-4.403, p < 0.001) for the increased risk of RA-related pulmonary disease due to the serum ACPA positivity. In the white population subgroup, an increased OR was 3.453 (95% CI 1.798-6.630, p < 0.001), whereas no association was found in the Asian population subgroup. Additionally, we further revealed that serum ACPA positivity indicated a higher risk for interstitial lung disease (ILD) and interstitial pulmonary fibrosis (IPF) among patients with RA (OR 4.679, 95% CI 2.071-10.572, p < 0.001). The heterogeneity, publication bias, and sensitivity analyses had no statistical significance in any group.Conclusion. To our knowledge. this is the first metaanalysis to reveal that serum ACPA positivity is highly associated with the risk of RA-related pulmonary disease, particularly in RA-related ILD and IPF.