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间质性膀胱炎/膀胱疼痛综合征患者自身免疫性疾病的风险:台湾一项基于全国人口的研究

Risk of Autoimmune Diseases in Patients With Interstitial Cystitis/Bladder Pain Syndrome: A Nationwide Population-Based Study in Taiwan.

作者信息

Yueh Hann-Ziong, Yang Min-Hsin, Huang Jing-Yang, Wei James Cheng-Chung

机构信息

Department of Medical Education, Chung Shan Medical University Hospital, Taichung, Taiwan.

Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan.

出版信息

Front Med (Lausanne). 2021 Sep 20;8:747098. doi: 10.3389/fmed.2021.747098. eCollection 2021.

Abstract

The association between autoimmune diseases (ADs) and interstitial cystitis/bladder pain syndrome (IC/BPS) has long been investigated. However, the lack of comprehensive descriptions of patients in the literature has made comparison and evaluation impossible. We aim to investigate the risk of systemic ADs in patients with IC/BPS in Taiwan using a population-based administrative database. This study evaluated 1,095 patients newly diagnosed with IC/BPS between 2000 and 2013, using data from Taiwan's National Health Insurance Research Database. These patients were randomly matched by demographic characteristics with a comparison cohort of individuals without IC/BPS at a ratio of 1:20. Cox proportional hazards regression analysis was used to analyze the risk of ADs, adjusting for age, sex, urbanization, length of hospital stay, and comorbidities adjustment. Sensitivity analysis by propensity score was used to adjust for confounding factors. The adjusted Hazard Ratio (aHR) of ADs for IC/BPS patients was 1.409 (95% CI 1.152-1.725). The subgroup analysis indicated that female or 45-60 years of age had a greater risk of ADs. Furthermore, the subgroup analysis of primary outcomes indicated that IC/BPS had greater incidence with Hashimoto's thyroiditis (aHR = 2.767, 95% CI 1.039-7.368), ankylosing spondylitis (aHR = 2.429, 95% CI 1.264-4.67), rheumatoid arthritis (aHR = 1.516, 95% CI 1.001-2.296), and Sjogren's syndrome (aHR = 1.962, 95% CI 1.37-2.809). IC/BPS was associated with the development of ADs in our study population, especially Hashimoto's thyroiditis, ankylosing spondylitis, rheumatoid arthritis, and Sjogren's syndrome. Clinicians are recommended to be alert to the increased likelihood of developing ADs, particularly for middle-aged women.

摘要

自身免疫性疾病(ADs)与间质性膀胱炎/膀胱疼痛综合征(IC/BPS)之间的关联长期以来一直受到研究。然而,文献中缺乏对患者的全面描述,使得比较和评估变得不可能。我们旨在利用基于人群的行政数据库,调查台湾IC/BPS患者发生全身性ADs的风险。本研究使用台湾国民健康保险研究数据库的数据,评估了2000年至2013年间新诊断为IC/BPS的1095例患者。这些患者按人口统计学特征与无IC/BPS的对照队列以1:20的比例进行随机匹配。采用Cox比例风险回归分析来分析ADs的风险,并对年龄、性别、城市化程度、住院时间和合并症进行调整。使用倾向评分进行敏感性分析以调整混杂因素。IC/BPS患者发生ADs的调整后风险比(aHR)为1.409(95%置信区间1.152 - 1.725)。亚组分析表明,女性或45至60岁的患者发生ADs的风险更高。此外,主要结局的亚组分析表明,IC/BPS与桥本甲状腺炎(aHR = 2.767,95%置信区间1.039 - 7.368)、强直性脊柱炎(aHR = 2.429,95%置信区间1.264 - 4.67)、类风湿性关节炎(aHR = 1.516,95%置信区间1.001 - 2.296)和干燥综合征(aHR = 1.962,95%置信区间1.37 - 2.809)的发生率更高相关。在我们的研究人群中,IC/BPS与ADs的发生相关,尤其是桥本甲状腺炎、强直性脊柱炎、类风湿性关节炎和干燥综合征。建议临床医生警惕发生ADs的可能性增加,特别是对于中年女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fe6/8488113/fbe39e53fe95/fmed-08-747098-g0001.jpg

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