NATURAL HISTORY OF ARTHRITIS AND RHEUMATISM ON THE GILA RIVER INDIAN COMMUNITY

骨关节病、类风湿性关节炎的发生和发展 关节炎和强直性脊柱炎是通过 进行的临床、X光和血清学检查 每隔两年，在吉拉的成年人中前瞻性地 亚利桑那州的河印第安人社区（皮马印第安人）， 糖尿病的流行病学研究。 这项调查的目的是确定 这些疾病在人群中的分布，并确定 改变疾病进展的自然史。 主机 年龄、性别和包括HLA在内的各种基因标志物等因素 和Gm，以及各种潜在的环境 决定因素，如肥胖和暴露于 感染因子，将进行前瞻性研究，以确定其 与这些疾病的发展有关。 纵向 数据已经收集了22年的时间， 人口和代表一个独特的数据集，流行病学 关节炎的研究。 纵向数据已被用来确定发病率 类风湿性关节炎的发病率 与其他种族群体的类似数据进行了比较， 国家 类风湿因子作为一种免疫调节因子的预后意义 类风湿性关节炎的发病机制 确定了 发展中国家的风险 类风湿关节炎及其预后意义 与HLA-DR分型有关的因素正在研究中。

The development and progression of osteoarthrosis, rheumatoid arthritis and ankylosing spondylitis are being determined by means of clinical, radiographic and serological examinations carried out prospectively at two-yearly intervals among adults of the Gila River Indian Community (Pima Indians) in Arizona, in conjunction with epidemiological studies of diabetes in the same community. The purpose of this investigation is to ascertain the determinants of these diseases in the population, and to identify factors which alter the natural history of progression of the disease. Host factors such as age, sex, and various gene markers including HLA and Gm, together with various potential environmental determinants, such as obesity and evidence of exposure to infectious agents, will be studied prospectively to determine their relationship to the development of these diseases. Longitudinal data have now been collected over a 22-year period in the population and represent a unique data set for epidemiological studies of arthritis. The longitudinal data have been used to determine the incidence of rheumatoid arthritis in the population and comparisons have been made with similar data from other ethnic groups and countries. The prognostic significance of rheumatoid factor as a predictive factor for the development of rheumatoid arthritis has been determined. The relationship between the risk of developing rheumatoid arthritis and prognostic significance of rheumatoid factor in relation to HLA-DR typing is being examined.