■血清抗核抗体(ANA)与类风湿关节炎(RA)之间的关系仍然未知。因此,我们的目的是在一项病例对照研究中评估血清ANA是否与RA风险增加相关.
■选取2018年1月至2022年12月在山东省立医院住院的类风湿关节炎患者为病例组,以同时患有其他类型关节炎的患者和健康人作为对照组。通过间接免疫荧光测定法检测抗核抗体(ANA)。采用倾向评分匹配来构建表现出可比基线特征的患者队列。采用logistic回归分析血清ANA与类风湿关节炎发病风险的关系。
■本研究共纳入1,175名RA患者和1,662名对照受试者。在调整了倾向评分匹配队列中的潜在混杂因素后,随着ANA滴度的升高,RA的风险逐渐增加。当ANA滴度分为三组(1:100、1:320和1:1,000)时,ANA滴度从低到高的OR(95%CI)为3.95(3.01,5.18),16.63(9.44,29.30),和17.34(9.53,31.54),分别,与ANA阴性时相比。与RA发生密切相关的ANA模式包括核同质,核斑点,细胞质斑点。其中,核均匀阳性率最高,占42.64%。ANA模式的OR(95%CI),包括核同质,核斑点,细胞质斑点为16.81(11.46,24.65),3.40(2.49,4.63),和3.09(1.77,5.40),分别。
■ANA滴度与RA之间存在曲线关系,ANA滴度越高,RA的概率越高。然而,1:320和1:1,000ANA滴度的RA概率无统计学差异.RA患者血液中最重要的ANA模式是核均匀。这些发现表明ANA可能是RA的新风险标志物。
UNASSIGNED: The relationship between serum antinuclear antibody (ANA) and rheumatoid arthritis (RA) remains unknown. Therefore, we aimed to evaluate whether serum ANA was associated with an increased risk of RA in a case-control study.
UNASSIGNED: Patients with rheumatoid arthritis hospitalized at Shandong Provincial Hospital from January 2018 to December 2022 were recruited as the case group, and patients with other types of arthritis and healthy people at the same time were taken as the control group. Antinuclear antibody (ANA) was detected by indirect immunofluorescence assays. Propensity score matching was employed to construct a cohort of patients exhibiting comparable baseline characteristics. The relationship between serum ANA and the risk of rheumatoid arthritis was analyzed by logistic regression analysis.
UNASSIGNED: A total of 1,175 patients with RA and 1,662 control subjects were included in this study. After adjusting for potential confounding factors in the propensity-score matched cohort, the risk of RA gradually increased with rising of ANA titers. When ANA titers were divided into three groups (1:100, 1:320, and 1:1,000), the OR (95% CI) for ANA titers from low to high was 3.95 (3.01, 5.18), 16.63 (9.44, 29.30), and 17.34 (9.53, 31.54), respectively, compared to those when ANA was negative. The ANA patterns closely related to the occurrence of RA include nuclear homogeneous, nuclear speckled, and cytoplasmic speckled. Among them, the positive rate of nuclear homogeneous was the highest, which accounted for 42.64%. The OR (95% CI) of ANA patterns including nuclear homogeneous, nuclear speckled, and cytoplasmic speckled was 16.81 (11.46, 24.65), 3.40 (2.49, 4.63), and 3.09 (1.77, 5.40), respectively.
UNASSIGNED: There was a curve relation between ANA titer and RA, and the higher the ANA titer, the higher the probability of RA. However, there was no statistical difference in probability of RA for 1:320 versus 1:1,000 ANA titers. The most important kind of ANA pattern in the blood of RA patients was nuclear homogeneous. These findings suggest that ANA may be a novel risk marker for RA.