Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis.
Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis.
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DOI：
10.1186/ar4498
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发表时间：
2014-03-05
影响因子：
4.9
通讯作者：
Wolk A
中科院分区：
文献类型：
--
作者：
Di Giuseppe D;Discacciati A;Orsini N;Wolk A
虽然先前的研究发现吸烟与类风湿性关节炎（RA）的风险有关，但剂量反应关系仍不清楚。这项荟萃分析定量总结了关于终生暴露于吸烟（评估为包年）与RA风险相关性的累积证据。通过检索1966年至2013年10月的MEDLINE和EMBASE确定了相关研究，没有限制。还审查了检索到的文章的参考文献列表。研究报告相对风险（RR）或比值比（OR）估计与95%置信区间（CI）之间的关联包年吸烟和类风湿性关节炎被纳入剂量反应随机效应荟萃回归分析。我们在荟萃分析中纳入了3项前瞻性队列研究和7项病例对照研究。其中包括4，552例RA病例。没有异质性的迹象（P异质性= 0.32），发表偏倚不影响结果。与从不吸烟者相比，在吸烟1至10包年的人群中，发生RA的风险增加了26%（RR = 1.26，95% CI 1.14至1.39），在吸烟超过20包年的人群中增加了一倍（21至30包年的RR = 1.94，95% CI 1.65至2.27）。RA的风险并没有随着暴露水平的增加而进一步增加（>40包-年的RR = 2.07，95% CI 1.15至3.73）。当比较各项研究的最高与最低包-年类别时，类风湿因子（RF）阳性RA病例（RR = 2.47，95% CI 2.02至3.02）的RA风险在统计学上显著高于RF阴性病例（RR = 1.58，95% CI 1.15至2.18）。终生吸烟与类风湿关节炎的风险呈正相关，即使是在终生暴露水平较低的吸烟者中。RA的风险并没有进一步增加与暴露高于20包-年。
Although previous studies found that cigarette smoking is associated with risk of rheumatoid arthritis (RA), the dose-response relationship remains unclear. This meta-analysis quantitatively summarizes accumulated evidence regarding the association of lifelong exposure to cigarette smoking assessed as pack-years with the risk of RA. Relevant studies were identified by a search of MEDLINE and EMBASE from 1966 to October 2013, with no restrictions. Reference lists from retrieved articles were also reviewed. Studies that reported relative risks (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs) for the association between pack-years of cigarette smoking and rheumatoid arthritis were included in a dose-response random-effects meta-regression analysis. We included 3 prospective cohorts and 7 case-control studies in the meta-analysis. They included a total of 4,552 RA cases. There was no indication of heterogeneity (Pheterogeneity = 0.32) and publication bias did not affect the results. Compared to never smokers, the risk of developing RA increased by 26% (RR = 1.26, 95% CI 1.14 to 1.39) among those who smoked 1 to 10 pack-years and doubled among those with more than 20 pack-years (RR for 21 to 30 pack years = 1.94, 95% CI 1.65 to 2.27). The risk of RA was not increasing further for higher exposure levels (RR for >40 pack-years = 2.07, 95% CI 1.15 to 3.73). The risk of RA was statistically significantly higher among rheumatoid factor (RF)-positive RA cases (RR = 2.47, 95% CI 2.02 to 3.02) compared to RF-negative (RR = 1.58, 95% CI 1.15 to 2.18) when comparing the highest versus lowest category of pack-years for the individual studies. Lifelong cigarette smoking was positively associated with the risk of RA even among smokers with a low lifelong exposure. The risk of RA did not further increase with an exposure higher than 20 pack-years.
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影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
影响因子：
2
作者：
Hamling, Jan;Lee, Peter;Ambuehl, Mathias
通讯作者：
Ambuehl, Mathias
影响因子：
27.4
作者：
Hutchinson, D;Shepstone, L;Lynch, MP
通讯作者：
Lynch, MP
影响因子：
5.5
作者：
Scott, DL
通讯作者：
Scott, DL
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N