title: Comorbidities in Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis versus the General Population.
abstract: To evaluate the consultation rates of selected comorbidities in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) compared with the general population in southern Sweden.
  
  
  
  We used data from a population-based cohort of patients with AAV diagnosed between 1998 and 2010 in Southern Sweden (701,000 inhabitants). For each patient we identified 4 reference subjects randomly sampled from the general population and matched for year of birth, sex, area of residence, and index year. Using the population-based Skåne Healthcare Register, we identified relevant diagnostic codes, registered between 1998 and 2011, for selected comorbidities assigned after the date of diagnosis of AAV or the index date for the reference subjects. We calculated rate ratios for comorbidities (AAV:reference subjects).
  
  
  
  There were 186 patients with AAV (95 women, mean age 64.5 yrs) and 744 reference persons included in the analysis. The highest rate ratios (AAV:reference) were obtained for osteoporosis (4.6, 95% CI 3.0-7.0), followed by venous thromboembolism (4.0, 95% CI 1.9-8.3), thyroid diseases (2.1, 95% CI 1.3-3.3), and diabetes mellitus (2.0, 95% CI 1.3-2.9). For ischemic heart disease, the rate ratio of 1.5 (95% CI 1.0-2.3) did not reach statistical significance. No statistically significant differences were found for cerebrovascular accidents.
  
  
  
  AAV is associated with increased consultation rates of several comorbidities including osteoporosis and thromboembolic and endocrine disorders. Comorbid conditions should be taken into consideration when planning and providing care for patients with AAV.
authors.affiliation: From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Englund
authors.affiliation: From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Merkel
authors.affiliation: From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tomasson
authors.affiliation: From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: Mårten
authors.initials: M
authors.lastname: Segelmark
authors.affiliation: From the Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, and Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund; Department of Nephrology, Linköping University, Linköping, Sweden; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Public Health Sciences, University of Iceland, Reykjavik, Iceland; the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK.M. Englund, MD, PhD, Clinical Epidemiology Unit, Orthopaedics, Clinical Sciences Lund, Lund University, and Clinical Epidemiology Research and Training Unit, Boston University School of Medicine; P.A. Merkel, MD, MPH, Penn Vasculitis Center, Division of Rheumatology, University of Pennsylvania; G. Tomasson, MD, Department of Public Health Sciences, University of Iceland; M. Segelmark, MD, PhD, Department of Nephrology, Linköping University; A.J. Mohammad, MD, PhD, Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, and the Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge, UK. Aladdin.mohammad@med.lu.se.
authors.forename: Aladdin J
authors.initials: AJ
authors.lastname: Mohammad
mesh_terms: D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology*
keywords: ANCA-ASSOCIATED VASCULITIS; ANTINEUTROPHIL CYTOPLASMIC ANTIBODIES; COMORBIDITIES; OUTCOME; POPULATION-BASED STUDY