Common co-morbidities in polymyalgia rheumatica and giant cell arteritis: cross-sectional study in UK Biobank

Charikleia Chatzigeorgiou; John C Taylor; Faye Elliott; Eoin P O'Sullivan; Ann W Morgan; Jennifer H Barrett; Sarah L Mackie

doi:10.1093/rap/rkad095

Common co-morbidities in polymyalgia rheumatica and giant cell arteritis: cross-sectional study in UK Biobank

Rheumatol Adv Pract. 2023 Nov 2;7(3):rkad095. doi: 10.1093/rap/rkad095. eCollection 2023.

Authors

Charikleia Chatzigeorgiou^{1

2}, John C Taylor^{1

3}, Faye Elliott¹, Eoin P O'Sullivan⁴, Ann W Morgan^{1

2

3

5}, Jennifer H Barrett^{1

2}, Sarah L Mackie^{1

2}

Affiliations

¹ School of Medicine, University of Leeds, Leeds, UK.
² NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
³ Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.
⁴ Department of Ophthalmology, King's College Hospital NHS Foundation Trust, London, UK.
⁵ NIHR Leeds Medicines and In Vitro Diagnostics Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Abstract

Objective: The aim was to determine prevalent co-morbidities in cases with PMR or GCA compared with matched controls.

Methods: This was a nested, cross-sectional case-control study within the UK Biobank, which recruited participants aged 40-69 years. Case status was defined as self-reported prior diagnosis of PMR or GCA. Ten controls per case were matched for age, sex, ethnicity and assessment centre. Associations with selected self-reported co-morbidities were studied using conditional logistic regression.

Results: Of PMR (n = 1036) or GCA (n = 102) cases, 72% were female, 98% White, and 58% reported current use of glucocorticoids. Mean age was 63 years. At the time of the assessment visit, compared with controls, PMR/GCA cases were more likely to report poor general health and at least several days of low mood in the past 2 weeks. PMR was associated with hypothyroidism [odds ratio (OR) = 1.34; 95% CI = 1.07, 1.67] and ever-use of HRT (OR = 1.26; 95% CI = 1.07, 1.47). Regarding common co-morbidities, PMR and GCA were both associated with hypertension (PMR: OR = 1.21; 95% CI = 1.06, 1.39; GCA: OR = 1.86; 95% CI = 1.23, 2.81) and cataract (PMR: OR = 1.51; 95% CI = 1.19, 1.93; GCA: OR = 3.84; 95% CI = 2.23, 6.60). Additionally, GCA was associated with depression (OR = 3.05; 95% CI = 1.59, 5.85). Neither condition was associated with diabetes.

Conclusion: Participants with a history of PMR/GCA, including those not currently taking glucocorticoids, rated their health as poorer than matched controls. Some previously described disease associations (hypothyroidism and early menopause) were replicated. Hypertension and cataract, both of which can be exacerbated by long-term glucocorticoid therapy, were over-represented in both diseases, particularly GCA.

Keywords: UK Biobank; co-morbidities; epidemiology; giant cell arteritis; polymyalgia rheumatica.