Comparison of threshold cutpoints and continuous measures of anti-cyclic citrullinated peptide antibodies in predicting future rheumatoid arthritis.
Comparison of threshold cutpoints and continuous measures of anti-cyclic citrullinated peptide antibodies in predicting future rheumatoid arthritis.
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DOI：
10.3899/jrheum.080895
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发表时间：
2009-04
期刊：
影响因子：
--
通讯作者：
Karlson EW
中科院分区：
文献类型：
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作者：
Chibnik LB;Mandl LA;Costenbader KH;Schur PH;Karlson EW
抗环瓜氨酸肽（抗CCP）抗体与类风湿性关节炎（RA）风险增加密切相关。虽然抗CCP抗体水平在临床应用中通常是二分的，但滴度作为预测RA发展的连续变量的最佳阈值和效用尚不确定。利用护士健康研究和护士健康研究II纵向队列的数据，我们研究了RA在抗CCP不同阈值下的敏感性、特异性和危险性。使用结缔组织疾病筛查问卷和医疗记录审查证实了62，437名参与者中的93名女性的RA事件。每个病例随机选择三个对照，匹配队列，年龄和绝经状态。用第二代Diastat™ ELISA测试储存的血浆的抗CCP抗体。五个阈值进行了评估的敏感性，特异性和时间诊断RA。RA的危险性进行了评估，条件logistic回归模型调整吸烟和生殖因素。采用抗CCP抗体阳性的建议阈值> 5 U/ml，特异性为100%，但敏感性仅为28%。阈值> 2 U/ml具有较高的灵敏度（51%）和相似的特异性（80%），RA的比值比为11.2（95%置信区间4.7-26.9）。抗CCP水平作为一个有序变量与RA发作时间密切相关，较高的值预测较短的RA发作时间。抗CCP抗体阳性的低阈值在预测RA发展中更敏感。较高的水平范围在预测RA发作时间方面提供了信息。
Anti-cyclic citrullinated peptide (anti-CCP) antibodies are strongly associated with increased risk of rheumatoid arthritis (RA). While the anti-CCP level is commonly dichotomized for clinical use, the best threshold for and utility of the titer as a continuous variable to predict development of RA are uncertain. Using data from the Nurses’ Health Study and Nurses’ Health Study II longitudinal cohorts, we examined the sensitivity, specificity, and hazard of RA at various thresholds of the anti-CCP. Incident RA was confirmed using the Connective Tissue Disease Screening Questionnaire and medical record review in 93 women from among 62,437 participants with blood samples. Three controls per case were randomly chosen, matching on cohort, age, and menopausal status. Stored plasma was tested for anti-CCP antibodies with the second-generation Diastat™ ELISA. Five threshold values were assessed for sensitivity, specificity, and time to diagnosis of RA. Hazard of RA was assessed with conditional logistic regression models adjusting for smoking and reproductive factors. Using the suggested threshold of > 5 U/ml for anti-CCP positivity, specificity was 100%, but sensitivity was only 28%. A threshold of > 2 U/ml had a higher sensitivity (51%), and similar specificity (80%), with an odds ratio of 11.2 (95% confidence interval 4.7–26.9) for RA. Anti-CCP level as an ordinal variable was strongly associated with time to RA onset, with higher values predicting shorter time to RA onset. A lower threshold for anti-CCP positivity was more sensitive in predicting RA development. Higher ranges of the level were informative in predicting time to RA onset.
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影响因子：
--
作者：
LIANG, MH;MEENAN, RF;SCHUR, PH
通讯作者：
SCHUR, PH
抗偶然柠檬硫化肽抗体和类风湿因子与类风湿关节炎的放射学严重程度的独立关联。
影响因子：
4.9
作者：
Mewar, Devesh;Coote, Annabel;Moore, David J;Marinou, Ioanna;Keyworth, Jodie;Dickson, Marion C;Montgomery, Doug S;Binks, Michael H;Wilson, Anthony G
通讯作者：
Wilson, Anthony G
影响因子：
--
作者：
PINCUS, T;CALLAHAN, LF;VAUGHN, WK
通讯作者：
VAUGHN, WK
影响因子：
4.9
作者：
Berglin, E;Padyukov, L;Dahlqvist, SR
通讯作者：
Dahlqvist, SR
影响因子：
27.4
作者：
Jorgensen, C;Picot, MC;Sany, J
通讯作者：
Sany, J