中国健康体检人群中抗 SSA 抗体的流行率和临床意义。

IF 3.4 3区 医学 Q3 IMMUNOLOGY Clinical and experimental immunology Pub Date : 2024-10-16 DOI:10.1093/cei/uxae073
Yimeng Jia, Shuqi Luan, Sicheng Huang, Wen Zhang, Mengtao Li, Tengda Xu, Yunyun Fei
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引用次数: 0

摘要

抗SSA抗体是一种非器官特异性自身抗体,在各种自身免疫性疾病中非常普遍。本研究主要调查健康检查人群中抗 SSA 抗体的流行情况。此外,我们还探讨了抗-SSA抗体阳性人群的临床特征,并评估了有随访记录的抗-SSA抗体阳性者多年来结缔组织疾病(CTD)的发展情况。对2013年至2022年期间到北京协和医院进行健康检查的64045名无CTD病史者进行了自身免疫抗体筛查。在中国健康筛查人群中,1.7%(1091/64045)的人抗SSA抗体呈阳性,男性患病率为0.9%(290/33829),女性患病率为2.7%(801/30216)。与匹配的自身抗体阴性对照组相比,抗SSA抗体阳性者的血清学异常水平更高,包括红细胞沉降率(ESR)[10 (6-15) mm/h vs. 7 (4-12) mm/h, p20 mm/h]、RF阳性(>20 IU/ml)和女性性别被认为是抗SSA抗体阳性者患CTD的独立危险因素。在大约 1000 名无自身免疫性疾病史的人中,有 17 人发现了抗-SSA 抗体。建议抗SSA抗体阳性者定期监测甲状腺功能。血沉增快(>20 mm/h)、女性和类风湿因子阳性者可能是CTD的高危人群。
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Prevalence and clinical significance of anti-SSA antibody in the Chinese health screening population.

Anti-Sjögren's syndrome type A (anti-SSA) antibodies are non-organ-specific autoantibodies highly prevalent in various autoimmune diseases. This study primarily investigated the prevalence of anti-SSA antibodies in the health screening population. Additionally, we explored the clinical features of the anti-SSA antibody-positive population and evaluated the development of connective tissue diseases (CTD) over the years in individuals with anti-SSA antibodies for whom follow-up was available. A total of, 64 045 individuals without a history of CTD from 2013 to 2022 who visited Peking Union Medical College Hospital for health screening were screened for autoimmune antibodies: 1.7% (1091/64 045) of the Chinese health screening population were positive for anti-SSA antibodies, with a prevalence of 0.9% (290/33 829) in men and 2.7% (801/30 216) in women. Compared with matched autoantibody-negative controls, anti-SSA antibody-positive individuals had higher levels of serological abnormalities, including erythrocyte sedimentation rate (ESR) [10 (6-15) mm/h vs. 7 (4-12) mm/h, P < 0.0001], rheumatoid factor (RF) [7.15 (4.30-16.90) IU/ml vs. 5.00 (3.20-7.90) IU/ml, P < 0.0001], and immunoglobulin G [13.09 (11.20-15.45) g/L vs. 11.34 (9.85-13.18) g/L, P < 0.0001], and lower levels of white blood cells (WBC; 5.49 ± 1.50 × 109/L vs. 5.82 ± 1.49 × 109/L, P < 0.0001). Additionally, they had a higher proportion of coexisting thyroid autoantibodies, including anti-thyroid peroxidase antibodies (TPO-Ab) (17.1% vs. 11.3%, P < 0.0001) and anti-thyroglobulin antibodies (Tg-Ab) (17.8% vs. 11.0%, P < 0.0001). Among the 381 subjects who were anti-SSA positive and followed up for a median of 4.6 years, 146 (38.3%) individuals developed CTD, including 68 (17.8%) cases of primary Sjögren's syndrome (pSS), 10 (2.6%) cases of rheumatoid arthritis (RA), 5 (1.3%) cases of systemic lupus erythematosus (SLE), 4 (1.0%) cases of secondary Sjögren's syndrome (sSS), and 59 (15.5%) cases of undifferentiated connective tissue disease (UCTD). In all, 235 (61.7%) individuals did not develop CTD over a median time of 5.9 (2.9-8.1) years after the earliest autoantibody detection. Elevated ESR (>20 mm/h), RF positivity (>20 IU/ml), and female gender were identified as independent risk factors for CTD among the anti-SSA antibody-positive individuals. Anti-SSA antibodies were found in 17 among approximately 1000 individuals without a history of autoimmune diseases. Anti-SSA antibody-positive individuals are advised to periodically monitor thyroid function. Elevated ESR (>20 mm/h), female gender, and RF positivity may delineate a high-risk cohort for CTDs.

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来源期刊
CiteScore
8.40
自引率
2.20%
发文量
101
审稿时长
3-8 weeks
期刊介绍: Clinical & Experimental Immunology (established in 1966) is an authoritative international journal publishing high-quality research studies in translational and clinical immunology that have the potential to transform our understanding of the immunopathology of human disease and/or change clinical practice. The journal is focused on translational and clinical immunology and is among the foremost journals in this field, attracting high-quality papers from across the world. Translation is viewed as a process of applying ideas, insights and discoveries generated through scientific studies to the treatment, prevention or diagnosis of human disease. Clinical immunology has evolved as a field to encompass the application of state-of-the-art technologies such as next-generation sequencing, metagenomics and high-dimensional phenotyping to understand mechanisms that govern the outcomes of clinical trials.
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