慢性扁桃体炎与 IgA 肾病:日本全国队列研究的发现

IF 9.4 1区 医学 Q1 UROLOGY & NEPHROLOGY American Journal of Kidney Diseases Pub Date : 2024-06-19 DOI:10.1053/j.ajkd.2024.04.015
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引用次数: 0

摘要

理由和目的:人们对慢性扁桃体炎与 IgA 肾病(IgAN)发病之间的关系知之甚少。本研究探讨了慢性扁桃体炎与 IgAN 发病风险之间的潜在关系:观察性队列研究:2005年1月至2022年5月期间,在日本全国流行病学数据库(JMDC索赔数据库)中发现的4,311,393名无IgAN病史的个体,该数据库代表了60多家保险公司的健康索赔:暴露:基于诊断代码的合并慢性扁桃体炎:分析方法分析方法:采用调整潜在混杂因素的特定原因 Cox 比例危险分析来估计危险比(HRs):结果:共发现12842人合并慢性扁桃体炎,占队列的0.3%。队列的中位年龄为 44 岁(四分位数间距:36-53 岁),男性占 57.9%,随访时间为 1,089 天(四分位数间距:532-1,797 天),期间有 2,653 例 IgAN 患者发病。累积发病率曲线显示,慢性扁桃体炎患者的 IgAN 累积发病率高于无慢性扁桃体炎的患者。多变量病因特异性分析进一步表明,慢性扁桃体炎患者罹患 IgAN 的风险较高,HR 为 2.72(95% 置信区间:1.79-4.14):局限性:潜在的残留混杂因素,缺乏对种族差异的考虑:通过大规模流行病学数据集,这些研究结果表明,在日本普通人群中,慢性扁桃体炎与 IgAN 发病风险升高之间存在关系。
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Chronic Tonsillitis and IgA Nephropathy: Findings From a Nationwide Japanese Cohort Study

Rationale & Objective

Little is known regarding the association between chronic tonsillitis and the onset of IgA nephropathy (IgAN). In the present study, we examined the potential relationship between chronic tonsillitis and a subsequent risk of developing IgAN.

Study Design

Observational cohort study.

Setting & Participants

4,311,393 individuals without a history of IgAN identified between January 2005 and May 2022 within a Japanese nationwide epidemiological database, the JMDC Claims Database, representing health claims to over 60 insurers.

Exposure

Comorbid chronic tonsillitis based on diagnosis codes.

Outcome

IgAN occurrence.

Analytical Approach

Cause-specific Cox proportional hazards analysis adjusting for potential confounding factors was employed to estimate hazard ratios (HRs).

Results

Comorbid chronic tonsillitis was identified in 12,842 individuals, constituting 0.3% of the cohort. The cohort had a median age of 44 years (IQR, 36-53), and males accounted for 57.9%, with a follow-up of 1,089 days (IQR, 532-1,797), during which 2,653 cases of IgAN developed. Cumulative incidence curve showed a higher cumulative incidence of IgAN in individuals with chronic tonsillitis compared with their counterparts without this condition. Multivariable cause-specific analysis further demonstrated that individuals with chronic tonsillitis had an elevated risk of developing IgAN, with HR of 2.72 (95% CI, 1.79-4.14).

Limitations

Potential residual confounders, and lack of consideration for ethnic distinctions.

Conclusions

Using a large-scale epidemiological dataset, these findings suggest a relationship between chronic tonsillitis and an elevated risk of IgAN development in the general Japanese population.

Plain-Language Summary

IgA nephropathy (IgAN), the most prevalent form of primary glomerulonephritis worldwide, is associated with unfavorable long-term kidney survival and life expectancy. Despite the substantial implications, the early detection of IgAN still remains challenging due to its commonly asymptomatic clinical presentation. Consequently, the exploration of risk factors assumes a critical research priority. Prior studies have reported the potential role of tonsilitis in the pathogenesis of IgAN. In this study, we assessed whether chronic tonsillitis was associated with the subsequent development of IgAN using a nationwide epidemiological dataset incorporating over 4,000,000 individuals. Within this large-scale cohort, our findings revealed an association between a history of tonsillitis and a greater risk of developing IgAN. These findings should heighten awareness of the potential susceptibility of people with chronic tonsilitis to IgAN.
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来源期刊
American Journal of Kidney Diseases
American Journal of Kidney Diseases 医学-泌尿学与肾脏学
CiteScore
20.40
自引率
2.30%
发文量
732
审稿时长
3-8 weeks
期刊介绍: The American Journal of Kidney Diseases (AJKD), the National Kidney Foundation's official journal, is globally recognized for its leadership in clinical nephrology content. Monthly, AJKD publishes original investigations on kidney diseases, hypertension, dialysis therapies, and kidney transplantation. Rigorous peer-review, statistical scrutiny, and a structured format characterize the publication process. Each issue includes case reports unveiling new diseases and potential therapeutic strategies.
期刊最新文献
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