Increasing age at symptom onset is associated with worse radiological damage at presentation in patients with early inflammatory polyarthritis
Increasing age at symptom onset is associated with worse radiological damage at presentation in patients with early inflammatory polyarthritis
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DOI：
10.1136/ard.2006.055657
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发表时间：
2007-03-01
影响因子：
27.4
通讯作者：
Symmons, Deborah
中科院分区：
文献类型：
--
作者：
Bukhari, Marwan;Lunt, Mark;Symmons, Deborah
背景：发病年龄增加与类风湿性关节炎预后不良相关，尽管来自非选定的初始队列的数据很少。假设：年龄增加与发病时侵蚀的风险增加相关，这种增加不能用与年龄相关的疾病混杂因素来解释。对象和方法：222名受试者(发病年龄中值为59岁)来自基于初级保健的新发炎症性多发性关节炎登记。患者在症状出现后12个月内拍摄了手部和足部X光片。电影由两位读者使用拉森评分进行评分。结果：年龄50-69岁、50-69岁、70岁起病年龄组与50岁、50岁、50岁年龄组牙周炎患病率分别为22%、52%、71%，两个年龄组的OR值(95%可信区间)分别为3.5(2.2~5.7)和7.4(4.5~12.1)。排除那些仅有近侧指间(PIP)侵蚀的患者(由于可能的骨关节炎)不会改变这些发现。使用Logistic回归对疾病特征进行调整并未减弱这些结果：50-69岁和<70岁年龄组的调整OR(95%CI)分别为3.6(2.1至6.1)和6.9(3.8至12.2)。在该队列中，年龄的影响比大多数疾病相关变量预测侵蚀的影响更大。结论：症状出现时年龄的增加与第一年内更高的侵蚀发生率密切相关，这是由于疾病的严重性更大。
Background: Increasing age at onset has been associated with worse outcome in rheumatoid arthritis, although there are few data from unselected inception cohorts.Hypothesis: Increasing age is associated with a higher risk of erosions at presentation, and this increase is not explained by age-related disease confounders.Subjects and methods: 222 subjects (median onset age 59 years) were studied from a primary-care-based register of new-onset inflammatory polyarthritis. Patients had hand and feet radiographs taken within 12 months from symptom onset. Films were scored by two readers using the Larsen score. The risk of erosions in those aged 50-69 and >= 70 years at onset was compared with the risk in those aged,50 years both before and after adjustment for possible age-related disease confounders.Result: The prevalences of erosions were 22%, 52% and 71% in those aged,50, 50-69 and >= 70 years at onset equivalent to odds ratios (ORs) (95% confidence intervals (CIs)) of 3.5 (2.2 to 5.7) and 7.4 (4.5 to 12.1), respectively, in the two older age groups. Excluding those with proximal interphalangeal (PIP) erosions alone (due to possible osteoarthritis) did not alter these findings. Adjustments for disease characteristics using logistic regression did not attenuate these findings: adjusted ORs (95% CIs) 3.6 (2.1 to 6.1) and 6.9 (3.8 to 12.2) for age groups 50-69 and >= 70 years, respectively. The influence of age was stronger than most of the disease-related variables in predicting erosions in this cohort.Conclusion: Increasing age at symptom onset is strongly associated with higher occurrence of erosions within the first year unexplained by greater disease severity.