RESUMEN
OBJECTIVES: To explore the human leucocyte antigen (HLA)-DRB1 allele frequency in Dupuytren's disease (DD). METHOD: HLA-DRB1 genotypes were analysed by sequence-specific primers (SSPs) in samples collected from 172 men participating in a nested case-control study on the clinical manifestations and progression of DD. Of those, 121 had signs of DD while 51 did not. Of the 121 men with DD, 49 had contracted fingers or had been operated on, while 72 had nodules or fibrous cords in the palms. Odds ratios (ORs) and 95% confidence interval (CIs) were used to evaluate the results. RESULTS: The HLA-DRB1*01 allele was observed in 26 of the 121 affected men (23.7%) but in only four of the controls (7.8%) (OR 3.22, 95% CI 1.06-9.75). The HLA-DRB1*01 allele frequency in those affected was 11%, while in the control group it was 4% (OR 3.07, 95% CI 1.05-9.03). CONCLUSIONS: This observation indicates a possible association of HLA-DRB1*01 with DD, but further studies are needed for confirmation.
Asunto(s)
Contractura de Dupuytren/epidemiología , Contractura de Dupuytren/genética , Cadenas HLA-DRB1/genética , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad/epidemiología , Predisposición Genética a la Enfermedad/genética , Genotipo , Encuestas Epidemiológicas , Humanos , Islandia/epidemiología , Masculino , Distribución por Sexo , Población Blanca/genéticaRESUMEN
OBJECTIVE: To assess the relation between alcohol consumption and Dupuytren's disease. DESIGN: The participants were recruited from a previous study on Dupuytren's disease carried out in 1981-82 as part of a cohort study. Men with Dupuytren's disease in the former study and a control group were invited. The groups were matched for age and smoking habits. SETTINGS: The study took place at the Heart Preventive Clinic in Reykjavik. PATIENTS: Of 244 invited participants, 193 (79.1%) responded to the invitation; 137 had Dupuytren's disease and 56 were disease-free. Participants were examined for the presence of Dupuytren's disease and answered a questionnaire about alcohol habits. MAIN OUTCOME MEASURES: Alcoholism, alcohol consumption and signs of Dupuytren's disease. RESULTS: Of the Dupuytren's group, 19 (13.9%) had been treated for alcoholism or were heavy drinkers compared to 8 (14.3%) of those without Dupuytren's disease (NS). Little or moderate alcohol consumption was reported in 78.1% of the Dupuytren's patients compared to 73.2% of the controls (NS). Total abstainers from alcohol were 11 (8.0%) in the Dupuytren's group compared to 7 (12.5%) in the control group (NS). CONCLUSION: Our findings do not support a positive association between the use of alcohol and Dupuytren's disease.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Alcoholismo/epidemiología , Contractura de Dupuytren/epidemiología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Comorbilidad , Femenino , Humanos , Islandia/epidemiología , Masculino , Distribución por Sexo , Fumar/epidemiologíaRESUMEN
OBJECTIVE: To evaluate the clinical manifestations and progression of Dupuytren's disease. METHODS: In 1981-82 a total of 1297 men were examined for Dupuytren's disease, and of these 19.2% had the disease. In 1999 those with signs of the disease in 1981-82 were invited for a follow-up study. As controls symptom free individuals from the study in 1981-82 were invited. RESULTS: A total of 53 individuals from the control group had developed Dupuytren's disease in 1999. Men with palmar nodules/fibrous cord in 1981-82 were more likely to develop contracted fingers than those without Dupuytren's disease. Patients with young age at disease onset more often required operations than those with later onset. Of the men who had been operated 70% still had finger contractures in 1999. CONCLUSION: The incidence of Dupuytren's disease is high in elderly men. Dupuytren's disease is progressive in nature and most operated patients have recurrent finger contractures.
Asunto(s)
Contractura de Dupuytren/patología , Adulto , Anciano , Progresión de la Enfermedad , Contractura de Dupuytren/epidemiología , Contractura de Dupuytren/cirugía , Femenino , Dedos/patología , Estudios de Seguimiento , Humanos , Islandia/epidemiología , Masculino , Persona de Mediana EdadRESUMEN
Dupuytren's disease or palmar fibromatosis is a common disabling hand disorder, mainly confined to Caucasians of northwestern European origin. The prevalence of Dupuytren's disease and possible risk factors related to the disease were evaluated in a random sample of 1297 males and 868 females, aged 46 to 74 years. Blood samples were collected and biochemical parameters were evaluated. The possible relation between the disease and clinical, social, and biochemical parameters were estimated with age-adjusted univariate logistic regression analysis. Altogether 19.2% of the males and 4.4% of the female participants had clinical signs of Dupuytren's disease. The prevalence increased with age, from 7.2% among males in the age group 45-49 years up to 39.5% in those 70-74 years old. The more severe form of the disease, finger contractures, was found in 5.0% of the men and 1.4% had required operation, while this was rarely seen among women. In men elevated fasting blood glucose (P < 0.04), low body weight, and body mass index were significantly correlated with the presence of the disease (P < 0.001). Dupuytren's disease was common among heavy smokers (P = 0.02) and those having manual labor as occupation (P = 0.018). These results show that Dupuytren's disease is common in the Icelandic population and occupation and lifestyle seem to be related to the disease.
Asunto(s)
Contractura de Dupuytren/epidemiología , Anciano , Glucemia , Estudios de Cohortes , Contractura de Dupuytren/sangre , Contractura de Dupuytren/etiología , Femenino , Humanos , Islandia/epidemiología , Estilo de Vida , Modelos Logísticos , Masculino , Persona de Mediana Edad , Ocupaciones , Prevalencia , Distribución Aleatoria , Factores Sexuales , Fumar/efectos adversosRESUMEN
Previous reports have indicated that inflammatory mechanisms may be involved in the pathogenesis of Dupuytren's disease and it has even been suggested that this condition is a T-cell mediated autoimmune disorder. We investigated peripheral blood lymphocyte subsets from 21 patients with Dupuytren's disease and compared them with ten healthy blood donors. The Dupuytren's patients had an increase in DR+ T-cells compared with healthy controls. Furthermore, patients with both palmar and plantar involvement had a higher percentage of DR+ T-cells than those with only the palm affected. The percentage of circulating CD5+ B-cells was lower in the Dupuytren's patients compared with the control group; this feature was marginally significant for the whole group of Dupuytren's patients but was strongest in the group of patients with both palmar and plantar involvement. These findings support previous suggestions that immunological mechanisms, involving activated T-cells and probably also B-cells, are involved in the pathogenesis of Dupuytren's disease.