Antinuclear antibodies and mortality in the National Health and Nutrition Examination Survey (1999-2004)

作者：Dinse Gregg E; Parks Christine G; Weinberg Clarice R; Meier Helen C S; Co Carol A; Chan Edward K L; Miller Frederick W^*

来源：PLos One, 2017, 12(10): e0185977.

DOI：10.1371/journal.pone.0185977

Objective
Recent studies suggest antinuclear antibodies (ANA) may be related to mortality risk, but evidence is sparse and inconclusive. Thus, we investigated ANA associations with all-cause and cause-specific mortality in U.S. adults.
Methods
Our sample included 3357 adults (ages >= 20 years) from the 1999-2004 National Health and Nutrition Examination Survey with ANA measurements (1: 80 dilution) and mortality data through 2011 (median follow-up: 9.4 years). We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) via weighted Cox regression to assess ANA associations with mortality from all causes, cardiovascular disease (CVD), and cancer. Models adjusted for age, sex, race/ethnicity, education, and obesity. Analyses examined mortality in the full sample and in subgroups based on self-reported histories of CVD and cancer, both overall and stratified by sex and age at enrollment.
Results
Overall, ANA were not strongly associated with death from all causes (HR: 1.13; CI: 0.79, 1.60), from CVD (HR: 1.60; CI: 0.80, 3.20), or from cancer (HR: 1.58; CI: 0.75, 3.33), though all three HR estimates exceeded 1. In the subgroup with a history of cancer, ANA were associated with elevated all-cause mortality in men (HR: 2.28; CI: 1.01, 5.14) and in participants who enrolled at age >= 75 years (HR: 1.99; CI: 1.04, 3.80).
Conclusion
These findings suggest that ANA are not strongly associated with mortality in the general population. Longitudinal studies with repeated assessments are needed to understand the temporal relationship between ANA, aging-associated diseases, and mortality.

• 出版日期2017-10-9
• 单位NIH