Alcohol consumption is associated with lower self-reported disease activity and better health-related quality of life in female rheumatoid arthritis patients in Sweden: data from BARFOT, a multicenter study on early RA

BMC Musculoskeletal Disorders

Maria K Söderlin¹  Maria L Andersson¹  Sofia Symeonidou¹  Stefan Bergman¹ 

[1] Research and Development Center, Spenshult Rheumatology Hospital, Oskarström SE-313 92, Sweden

关键词: Health-related quality of life;    EULAR response criteria;    Alcohol;    Rheumatoid arthritis;   

Others  :  1130187
DOI  :  10.1186/1471-2474-14-218

 received in 2013-01-03, accepted in 2013-07-19,  发布年份 2013

【 摘 要 】

Background

Earlier studies have found a positive effect of alcohol consumption, with a reduced disease activity in rheumatoid arthritis (RA). The aim of this study was to assess alcohol consumption and its association with disease activity and health related quality of life (HRQL) in Swedish RA patients.

Methods

Between 1992 and 2005, 2,800 adult patients were included in the BARFOT study of early RA in Sweden. In 2010 a self-completion postal questionnaire was sent to all 2,102 prevalent patients in the BARFOT study enquiring about disease severity, HRQL, and lifestyle factors. Alcohol consumption was assessed using the validated AUDIT-C questionnaire.

Results

A total of 1,238 out of 1,460 patients answering the questionnaire had data on alcohol consumption: 11% were non-drinkers, 67% had a non-hazardous drinking, and 21% were classified as hazardous drinkers. Women who drank alcohol reported lower disease activity and better HRQL, but there were no association between alcohol consumption and disease activity in men. For current smokers, alcohol use was only associated with fewer patient-reported swollen joints. The outcome was not affected by kind of alcohol consumed.

Conclusions

There was an association between alcohol consumption and both lower self-reported disease activity and higher HRQL in female, but not in male, RA patients.

【 授权许可】

   
2013 Bergman et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Jonsson IM, Verdrengh M, Brisslert M, Lindblad S, Bokarewa M, Islander U, Carlsten H, Ohlsson C, Nandakumar KS, Holmdahl R, et al.: Ethanol prevents development of destructive arthritis. Proc Natl Acad Sci U S A 2007, 104(1):258-263.
• [2]Maxwell JR, Gowers IR, Moore DJ, Wilson AG: Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis. Rheumatology (Oxford, England) 2010, 49(11):2140-2146.
• [3]Nissen MJ, Gabay C, Scherer A, Finckh A: The effect of alcohol on radiographic progression in rheumatoid arthritis. Arthritis and rheumatism 2010, 62(5):1265-1272.
• [4]Pedersen M, Jacobsen S, Klarlund M, Pedersen BV, Wiik A, Wohlfahrt J, Frisch M: Environmental risk factors differ between rheumatoid arthritis with and without auto-antibodies against cyclic citrullinated peptides. Arthritis research & therapy 2006, 8(4):R133. BioMed Central Full Text
• [5]Kallberg H, Jacobsen S, Bengtsson C, Pedersen M, Padyukov L, Garred P, Frisch M, Karlson EW, Klareskog L, Alfredsson L: Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case–control studies. Ann Rheum Dis 2009, 68(2):222-227.
• [6]Forslind K, Ahlmen M, Eberhardt K, Hafstrom I, Svensson B: Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis 2004, 63(9):1090-1095.
• [7]Hafstrom I, Rohani M, Deneberg S, Wornert M, Jogestrand T, Frostegard J: Effects of low-dose prednisolone on endothelial function, atherosclerosis, and traditional risk factors for atherosclerosis in patients with rheumatoid arthritis–a randomized study. J Rheumatol 2007, 34(9):1810-1816.
• [8]Svensson B, Ahlmen M, Forslind K: Treatment of early RA in clinical practice: a comparative study of two different DMARD/corticosteroid options. Clin Exp Rheumatol 2003, 21(3):327-332.
• [9]Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS, et al.: The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988, 31(3):315-324.
• [10]Ekdahl C, Eberhardt K, Andersson SI, Svensson B: Assessing disability in patients with rheumatoid arthritis. use of a Swedish version of the stanford health assessment questionnaire. Scand J Rheumatol 1988, 17(4):263-271.
• [11]Fries JF, Spitz P, Kraines RG, Holman HR: Measurement of patient outcome in arthritis. Arthritis Rheum 1980, 23(2):137-145.
• [12]Kind P, Dolan P, Gudex C, Williams A: Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 1998, 316(7133):736-741.
• [13]The EuroQol Group: EuroQol--a new facility for the measurement of health-related quality of life. Health Policy 1990, 16(3):199-208.
• [14]Brooks RG, Jendteg S, Lindgren B, Persson U, Bjork S: EuroQol: health-related quality of life measurement. Results of the Swedish questionnaire exercise. Health Policy 1991, 18(1):37-48.
• [15]Hurst NP, Jobanputra P, Hunter M, Lambert M, Lochhead A, Brown H: Validity of Euroqol–a generic health status instrument–in patients with rheumatoid arthritis. economic and health outcomes research group. Br J Rheumatol 1994, 33(7):655-662.
• [16]Hurst NP, Kind P, Ruta D, Hunter M, Stubbings A: Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D). Br J Rheumatol 1997, 36(5):551-559.
• [17]Fleming MF, Barry KL, MacDonald R: The alcohol use disorders identification test (AUDIT) in a college sample. Int J Addict 1991, 26(11):1173-1185.
• [18]Medina-Mora E, Carreno S, De la Fuente JR: Experience with the alcohol use disorders identification test (AUDIT) in Mexico. Recent Dev Alcohol 1998, 14:383-396.
• [19]Holmila M: Intoxication and hazardous use of alcohol: results from the 1992 finnish drinking habits study. Addiction 1995, 90(6):785-792.
• [20]Gmel G, Heeb JL, Rehm J: Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland. Drug Alcohol Depend 2001, 64(2):151-163.
• [21]Selin KH: Alcohol use disorder identification test (AUDIT): what does it screen? Performance of the AUDIT against four different criteria in a swedish population sample. Subst Use Misuse 2006, 41(14):1881-1899.
• [22]Harris AH, Bradley KA, Bowe T, Henderson P, Moos R: Associations between AUDIT-C and mortality vary by age and sex. Popul Health Manag 2010, 13(5):263-268.
• [23]Rubinsky AD, Kivlahan DR, Volk RJ, Maynard C, Bradley KA: Estimating risk of alcohol dependence using alcohol screening scores. Drug Alcohol Depend 2010, 108(1–2):29-36.
• [24]Meneses-Gaya C, Zuardi AW, Loureiro SR, Hallak JE, Trzesniak C, de Azevedo Marques JM, Machado-de-Sousa JP, Chagas MH, Souza RM, Crippa JA: Is the full version of the AUDIT really necessary? study of the validity and internal construct of its abbreviated versions. Alcohol Clin Exp Res 2010, 34(8):1417-1424.
• [25]Kaarne T, Aalto M, Kuokkanen M, Seppa K: AUDIT-C, AUDIT-3 and AUDIT-QF in screening risky drinking among finnish occupational health-care patients. Drug Alcohol Rev 2010, 29(5):563-567.
• [26]Aalto M, Alho H, Halme JT, Seppa K: AUDIT and its abbreviated versions in detecting heavy and binge drinking in a general population survey. Drug Alcohol Depend 2009, 103(1–2):25-29.
• [27]Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA: The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory care quality improvement project (ACQUIP). alcohol Use disorders identification test. Arch Intern Med 1998, 158(16):1789-1795.
• [28]Forslind K, Hafstrom I, Ahlmen M, Svensson B: Sex: a major predictor of remission in early rheumatoid arthritis? Ann Rheum Dis 2007, 66(1):46-52.
• [29]Soderlin MK, Petersson IF, Bergman S, Svensson B: Smoking at onset of rheumatoid arthritis (RA) and its effect on disease activity and functional status: experiences from BARFOT, a long-term observational study on early RA. Scand J Rheumatol 2011, 40(4):249-255.
• [30]Nelson S, Kolls JK: Alcohol, host defence and society. Nat Rev Immunol 2002, 2(3):205-209.
• [31]Khoruts A, Stahnke L, McClain CJ, Logan G, Allen JI: Circulating tumor necrosis factor, interleukin-1 and interleukin-6 concentrations in chronic alcoholic patients. Hepatology 1991, 13(2):267-276.
• [32]Szabo G, Mandrekar P, Girouard L, Catalano D: Regulation of human monocyte functions by acute ethanol treatment: decreased tumor necrosis factor-alpha, interleukin-1 beta and elevated interleukin-10, and transforming growth factor-beta production. Alcohol Clin Exp Res 1996, 20(5):900-907.
• [33]Volpato S, Pahor M, Ferrucci L, Simonsick EM, Guralnik JM, Kritchevsky SB, Fellin R, Harris TB: Relationship of alcohol intake with inflammatory markers and plasminogen activator inhibitor-1 in well-functioning older adults: the health, aging, and body composition study. Circulation 2004, 109(5):607-612.
• [34]Perrino AC Jr, Ralevski E, Acampora G, Edgecombe J, Limoncelli D, Petrakis IL: Ethanol and pain sensitivity: effects in healthy subjects using an acute pain paradigm. Alcohol Clin Exp Res 2008, 32(6):952-958.
• [35]Soderlin MK, Bergman S: Absent "window of opportunity" in smokers with short disease duration. Data from BARFOT, a multicenter study of early rheumatoid arthritis. J Rheumatol 2011, 38(10):2160-2168.
• [36]Soderlin M, Petersson I, Geborek P: The effect of smoking on response and drug survival in rheumatoid arthritis patients treated with their first anti-TNF drug. Scand J Rheumatol 2012, 41(1):1-9.
• [37]Saevarsdottir S, Wedren S, Seddighzadeh M, Bengtsson C, Wesley A, Lindblad S, Askling J, Alfredsson L, Klareskog L: Patients with early rheumatoid arthritis who smoke are less likely to respond to treatment with methotrexate and tumor necrosis factor inhibitors: observations from the epidemiological investigation of rheumatoid arthritis and the Swedish rheumatology register cohorts. Arthritis and rheumatism 2011, 63(1):26-36.
• [38]Saevarsdottir S, Wallin H, Seddighzadeh M, Ernestam S, Geborek P, Petersson IF, Bratt J, van Vollenhoven RF: Predictors of response to methotrexate in early DMARD naive rheumatoid arthritis: results from the initial open-label phase of the SWEFOT trial. Ann Rheum Dis 2011, 70(3):469-475.
• [39]Manfredsdottir VF, Vikingsdottir T, Jonsson T, Geirsson AJ, Kjartansson O, Heimisdottir M, Sigurdardottir SL, Valdimarsson H, Vikingsson A: The effects of tobacco smoking and rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritis. Rheumatology (Oxford, England) 2006, 45(6):734-740.
• [40]Wolfe F: The effect of smoking on clinical, laboratory, and radiographic status in rheumatoid arthritis. J Rheumatol 2000, 27(3):630-637.
• [41]Papadopoulos NG, Alamanos Y, Voulgari PV, Epagelis EK, Tsifetaki N, Drosos AA: Does cigarette smoking influence disease expression, activity and severity in early rheumatoid arthritis patients? Clin Exp Rheumatol 2005, 23(6):861-866.
• [42]Hyrich KL, Watson KD, Silman AJ, Symmons DP: Predictors of response to anti-TNF-alpha therapy among patients with rheumatoid arthritis: results from the British society for rheumatology biologics register. Rheumatology (Oxford, England) 2006, 45(12):1558-1565.
• [43]Abhishek A, Butt S, Gadsby K, Zhang W, Deighton CM: Anti-TNF-alpha agents are less effective for the treatment of rheumatoid arthritis in current smokers. J Clin Rheumatol 2010, 16(1):15-18.
• [44]Mattey DL, Brownfield A, Dawes PT: Relationship between pack-year history of smoking and response to tumor necrosis factor antagonists in patients with rheumatoid arthritis. J Rheumatol 2009, 36(6):1180-1187.
• [45]Kesteloot H: Alcohol intake and markers of inflammation. Eur Heart J 2004, 25(23):2075-2076.
• [46]Riazzoli J, Nilsson JA, Teleman A, Petersson IF, Rantapaa-Dahlqvist S, Jacobsson LT, van Vollenhoven RF: Patient-reported 28 swollen and tender joint counts accurately represent RA disease activity and can be used to assess therapy responses at the group level. Rheumatology (Oxford) 2010, 49(11):2098-2103.
• [47]Kavanaugh A, Lee SJ, Weng HH, Chon Y, Huang XY, Lin SL: Patient-derived joint counts are a potential alternative for determining disease activity score. J Rheumatol 2010, 37(5):1035-1041.
• [48]Soderlin MK, Jacobsson LT, Petersson IF, Englund M, Saxne T, Geborek P: Differences in longitudinal disease and treatment characteristics of patients with rheumatoid arthritis replying and not replying to a postal questionnaire. Experience from a biologics register in southern Sweden. J Rheumatol 2009, 36(6):1166-1169.
• [49]Kauppi M, Sokka T, Hannonen P: Survey nonresponse is associated with increased mortality in patients with rheumatoid arthritis and in a community population. J Rheumatol 2005, 32(5):807-810.
• [50]Krishnan E, Murtagh K, Bruce B, Cline D, Singh G, Fries JF: Attrition bias in rheumatoid arthritis databanks: a case study of 6346 patients in 11 databanks and 65,649 administrations of the health assessment questionnaire. J Rheumatol 2004, 31(7):1320-1326.