Smoking–gender interaction and risk for rheumatoid arthritis

Arthritis Research & Therapy

Eswar Krishnan³  Tuulikki Sokka²  Pekka Hannonen¹ 

[1] Jyväskylä Central Hospital, Jyväskylä, Finland

[2] Vanderbilt University, Nashville, Tennessee, USA

[3] Department of Medicine, Stanford University, Palo Alto, California, USA

关键词: smoking;    sex;    rheumatoid arthritis;    risk;    interaction;    etiology;   

Others  :  1101381
DOI  :  10.1186/ar750

 received in 2002-11-27, accepted in 2003-02-21,  发布年份 2003

【 摘 要 】

The present case–control study was conducted to investigate the relationship between smoking and rheumatoid arthritis, and to investigate formally the interaction between sex, smoking, and risk for developing rheumatoid arthritis. The study was performed in the Central District of Finland. Cases were patients with rheumatoid arthritis and the control group was a random sample of the general population. Logistic regression models were used to evaluate the effect of smoking on risk for rheumatoid arthritis, after adjusting for the effects of age, education, body mass index, and indices of general health and pain. Overall, 1095 patients with rheumatoid arthritis and 1530 control individuals were included. Patients were older, less well educated, more disabled, and had poorer levels of general health as compared with control individuals (all P < 0.01). Preliminary analyses revealed the presence of substantial statistical interaction between smoking and sex (P < 0.001). In separate multivariable analyses, past history of smoking was associated with increased risk for rheumatoid arthritis overall in men (odds ratio 2.0, 95% confidence interval 1.2–3.2) but not in women. Among men, this effect was seen only for rheumatoid factor-positive rheumatoid arthritis. There were significant interactions between smoking and age among women but not among men. We conclude that sex is a biologic effect modifier in the association between smoking and rheumatoid arthritis. The role of menopause in the etiology of rheumatoid arthritis merits further research.

【 授权许可】

   
2003 Krishnan et al., licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

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