DECREASING INCIDENCE AND PREVALENCE OF RHEUMATOID-ARTHRITIS IN PIMA-INDIANS OVER A 25-YEAR PERIOD
DECREASING INCIDENCE AND PREVALENCE OF RHEUMATOID-ARTHRITIS IN PIMA-INDIANS OVER A 25-YEAR PERIOD
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DOI：
10.1002/art.1780370808
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发表时间：
1994-08-01
影响因子：
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通讯作者：
BENNETT, PH
中科院分区：
文献类型：
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作者：
JACOBSSON, LTH;HANSON, RL;BENNETT, PH
目标。评价类风湿关节炎（RA）发病率的时间趋势。在1965-1990年期间，在亚利桑那州以人群为基础的皮马印第安人队列中发现了类风湿性关节炎的病例。在2894名受试者中，78例RA事件被确定。在控制口服避孕药或雌激素的使用和怀孕经历后，男性的年龄调整发病率下降了55% (p趋势= 0.225)，女性下降了57% （p趋势= 0.017）。在同一时期，活动性RA的年龄调整患病率在男性中下降了29% (P-trend = 0.63)，在女性中下降了40% （P-trend = 0.02）。在1990年，只有不到17%的已知类风湿性关节炎患者在服用慢效抗风湿药物（SAARDs）。在如此短的时间内，该人群中RA发病率和患病率的下降暗示了除外源性雌激素外的环境因素参与了该疾病的发病机制。然而，观察到的减少可能是由于RA患者使用SAARDs增加所致，这一可能性不能排除。
Objective. To evaluate temporal trends in the incidence of rheumatoid arthritis (RA).Methods. Incident cases of RA were identified among a population-based cohort of Pima Indians in Arizona over the period 1965-1990.Results. Among 2,894 subjects, 78 incident cases of RA were identified. The age-adjusted incidence declined by 55% in men (P-trend = 0.225), and by 57% in women (P-trend = 0.017) after controlling for oral contraceptive or estrogen use and for pregnancy experience. During the same period, age-adjusted prevalence rates of active RA decreased by 29% in men (P-trend = 0.63) and by 40% in women (P-trend = 0.02). Fewer than 17% of subjects with known RA were taking slow-acting antirheumatic drugs (SAARDs) in 1990.Conclusion. The decrease in incidence and prevalence of RA in this population over such a short period implicates the involvement of an environmental factor(s), other than exogenous estrogens, in the pathogenesis of the disease. However, the possibility that the observed decrease might be explained by an increased use of SAARDs in subjects with RA cannot be excluded.