Familial aggregation of sarcoidosis - A Case-Control Etiologic Study of Sarcoidosis (ACCESS)
Familial aggregation of sarcoidosis - A Case-Control Etiologic Study of Sarcoidosis (ACCESS)
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DOI：
10.1164/ajrccm.164.11.2106001
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发表时间：
2001-12-01
影响因子：
24.7
通讯作者：
Cherniack, R
中科院分区：
文献类型：
--
作者：
Rybicki, BA;Iannuzzi, MC;Cherniack, R
尽管报告了结节病的家族聚集性，但很少有经验证据表明结节病病例的家庭成员的疾病风险大于一般人群。为了解决这个问题，我们利用1996年至1999年参加多中心ACCESS（结节病病例对照病因学研究）研究的706例年龄、性别、种族和地理位置匹配的病例和对照的10，862名一级亲属和17，047名二级亲属的疾病发生数据来估计结节病家族性相对风险。使用逻辑回归技术计算家族相对危险度估计值，该技术考虑了亲属之间的依赖性。同胞的相对风险最高（比值比[OR] = 5.8; 95%置信区间[CI] 2.1-15.9），其次是伯父关系（OR 5.7; 95% CI = 1.6-20.7），祖父母（OR 5.2; 95% CI = 1.5-18.0），然后是父母（OR = 3.8; 95% CI 1.2-11.3）。在一个多变量模型拟合的父母和兄弟姐妹的数据，家庭的相对风险调整年龄，性别，相对类，和共享的环境是4.7（95%CI = 2.3-9.7）。白色病例与非裔美国人病例相比有明显更高的家族性相对风险（18.0比2.8; p=0.098）。总之，与匹配的对照受试者的亲属相比，在结节病病例的一级和二级亲属中观察到结节病的风险显著升高。
Despite reports of familial clustering of sarcoidosis, little empirical evidence exists that disease risk in family members of sarcoidosis cases is greater than that in the general population. To address this question, we estimated sarcoidosis familial relative risk using data on disease occurrence in 10,862 first- and 17,047 second-degree relatives of 706 age, sex, race, and geographically matched cases and controls who participated in the multicenter ACCESS (A Case-Control Etiology Study of Sarcoidosis) study from 1996 to 1999. Familial relative risk estimates were calculated using a logistic regression technique that accounted for the dependence between relatives. Sibs had the highest relative risk (odds ratio [OR] = 5.8; 95% confidence interval [CI] 2.1-15.9), followed by avuncular relationships (OR 5.7; 95% CI = 1.6-20.7), grandparents (OR 5.2; 95% CI = 1.5-18.0), and then parents (OR = 3.8; 95% CI 1.2-11.3). In a multivariate model fit to the parents and sibs data, the familial relative risk adjusted for age, sex, relative class, and shared environment was 4.7 (95% CI = 2.3-9.7). White cases had a markedly higher familial relative risk compared with African-American cases (18.0 versus 2.8; p=0.098). In summary, a significant elevated risk of sarcoidosis was observed among first- and second-degree relatives of sarcoidosis cases compared with relatives of matched control subjects.