Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis
Traditional cardiovascular risk factors measured prior to the onset of inflammatory polyarthritis
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DOI：
10.1093/rheumatology/keh161
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发表时间：
2004-06-01
期刊：
影响因子：
5.5
通讯作者：
Symmons, DPM
中科院分区：
文献类型：
--
作者：
Goodson, NJ;Silman, AJ;Symmons, DPM
背景血清阳性炎性多关节炎（IP）患者的心血管死亡率增加。我们测试了这一假设，即心血管疾病（CVD）的风险增加可以解释为传统的CVD危险因素水平升高的人之前，IP的发展。在一项基于人群的前瞻性巢式病例对照研究中，25600名年龄在45-75岁之间的人在1993年至1997年期间参加了一项健康调查，包括标准CVD风险因素评估。在随访至2001年7月底期间，发现了91例IP事件（三分之一在就诊时血清反应阳性）。将IP病例的基线CVD危险因素与两个年龄/性别匹配的对照组进行比较。目前吸烟者IP的比值比为2.0（95% CI 1.0-4.0）。其他风险因素，包括总胆固醇和低密度脂蛋白胆固醇、收缩压和舒张压以及肥胖，在病例和对照组之间没有显着差异。重要的是，结合使用标准冠心病风险评分，这些因素与未来IP仅存在适度相关性，并且当分析仅限于少数血清阳性病例时，没有相关性。在传统的心血管风险因素中，只有吸烟会在IP发作前增加CVD风险。因此，在这些患者中观察到的CVD增加可能是关节炎发作后因素作用的结果。
Background. Cardiovascular mortality is increased in patients with seropositive inflammatory polyarthritis (IP). We tested the hypothesis that the increased risk of cardiovascular disease (CVD) can be explained by elevated traditional CVD risk factor levels in persons prior to development of IP.Methods. In a population-based, prospective nested case-control study, 25 600 people aged 45-75 yr participated in a health survey, including standard CVD risk factor assessment, between the years 1993 and 1997. There were 91 incident IP cases (one-third were seropositive at presentation) identified during follow-up to the end of July 2001. Baseline CVD risk factors in the IP cases were compared with those in two age/gender-matched controls.Results. Current smokers had an odds ratio of 2.0 (95% CI 1.0-4.0) for IP. Other risk factors, including total and LDL cholesterol, systolic and diastolic blood pressure and obesity, did not differ significantly between cases and controls. Importantly, in combination, using a standard coronary disease risk score, these factors only had a modest association with future IP, and no association when analysis was restricted to the smaller number of cases who were seropositive.Conclusion. Of the traditional cardiovascular risk factors, only smoking increases CVD risk prior to the onset of IP. Therefore the increased CVD observed in these patients is likely to be a consequence of factors operating after the onset of the arthritis.