{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:36:35Z","timestamp":1791045395899,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["HHSN273201600011C"],"award-info":[{"award-number":["HHSN273201600011C"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["Z01-ES025041"],"award-info":[{"award-number":["Z01-ES025041"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["Z01-ES101074"],"award-info":[{"award-number":["Z01-ES101074"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["GS-00F-173CA\/75N96021F00109"],"award-info":[{"award-number":["GS-00F-173CA\/75N96021F00109"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Growing evidence suggests increasing frequencies of autoimmunity and autoimmune diseases, but findings are limited by the lack of systematic data and evolving approaches and definitions. This study was undertaken to investigate whether the prevalence of antinuclear antibodies (ANA), the most common biomarker of autoimmunity, changed over a recent 25\u2010year span in the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Serum ANA were measured by standard indirect immunofluorescence assays on HEp\u20102 cells in 13,519 participants age\u2009\u226512\u2009years from the National Health and Nutrition Examination Survey, with approximately one\u2010third from each of 3 time periods: 1988\u20131991, 1999\u20132004, and 2011\u20132012. We used logistic regression adjusted for sex, age, race\/ethnicity, and survey design variables to estimate changes in ANA prevalence across the time periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of ANA was 11.0% (95% confidence interval [95% CI] 9.7\u201312.6%) in 1988\u20131991, 11.4% (95% CI 10.2\u201312.8%) in 1999\u20132004, and 16.1% (95% CI 14.4\u201318.0%) in 2011\u20132012 (\n                      <jats:italic>P<\/jats:italic>\n                      for trend &lt;0.0001), corresponding to ~22.3 million, ~26.6 million, and\u2009~41.5 million affected individuals, respectively. Among adolescents age 12\u201319\u2009years, ANA prevalence increased substantially, with odds ratios of 2.07 (95% CI 1.18\u20133.64) and 2.77 (95% CI 1.56\u20134.91) in the second and third time periods relative to the first (\n                      <jats:italic>P<\/jats:italic>\n                      for trend\u00a0=\u00a00.0004). ANA prevalence increased in both sexes (especially in men), older adults (age\u2009\u226550\u2009years), and non\u2010Hispanic white individuals. These increases in ANA prevalence were not explained by concurrent trends in weight (obesity\/overweight), smoking exposure, or alcohol consumption.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of ANA in the US has increased considerably in recent years. Additional studies to determine factors underlying these increases in ANA prevalence could elucidate causes of autoimmunity and enable the development of preventative measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.42330","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T06:21:45Z","timestamp":1661494905000},"page":"2032-2041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Increasing Prevalence of Antinuclear Antibodies in the United States"],"prefix":"10.1002","volume":"74","author":[{"given":"Gregg E.","family":"Dinse","sequence":"first","affiliation":[{"name":"Social &amp; Scientific Systems, a DLH Holding Corp. Company  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-3456","authenticated-orcid":false,"given":"Christine G.","family":"Parks","sequence":"additional","affiliation":[{"name":"Epidemiology Branch, National Institute of Environmental Health Sciences, NIH  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarice R.","family":"Weinberg","sequence":"additional","affiliation":[{"name":"Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroll A.","family":"Co","sequence":"additional","affiliation":[{"name":"Social &amp; Scientific Systems, a DLH Holding Corp. 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L.","family":"Chan","sequence":"additional","affiliation":[{"name":"University of Florida Health Science Center  Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2831-9593","authenticated-orcid":false,"given":"Frederick W.","family":"Miller","sequence":"additional","affiliation":[{"name":"Clinical Research Branch, National Institute of Environmental Health Sciences, NIH  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200108023450506"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12395"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020100"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.12691\/ijcd-3-4-8"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4091-4"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1610187"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.119-a248"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34380"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-0429"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37801"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2009.11.012"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2012.05.002"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.1409345"},{"key":"e_1_2_7_15_1","first-page":"1","article-title":"National health and nutrition examination survey: analytic guidelines, 1999\u20102010","author":"Johnson CL","year":"2013","journal-title":"Vital Health Stat"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214436"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0961203316657434"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021933"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2018.05.004"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32834ddb27"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.022624"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.05.011"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.09.001"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.01.001"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23703"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22945"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12225"},{"key":"e_1_2_7_28_1","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1136\/annrheumdis-2017-212599","article-title":"Assay variation in the detection of antinuclear antibodies in the sera of patients with established SLE","volume":"77","author":"Pisetsky DS","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30084"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/1744666X.2019.1596802"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2015.00412"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201602-095AW"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.130948"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/000992280404300709"}],"updated-by":[{"DOI":"10.1002\/art.41214","type":"retraction","label":"Retraction","source":"publisher","updated":{"date-parts":[[2020,4,30]],"date-time":"2020-04-30T00:00:00Z","timestamp":1588204800000}}],"container-title":["Arthritis &amp; 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