LIFE-STYLE AND THE RISK OF RHEUMATOID-ARTHRITIS - CIGARETTE-SMOKING AND ALCOHOL-CONSUMPTION
LIFE-STYLE AND THE RISK OF RHEUMATOID-ARTHRITIS - CIGARETTE-SMOKING AND ALCOHOL-CONSUMPTION
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DOI：
10.1136/ard.49.12.980
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发表时间：
1990-12-01
影响因子：
27.4
通讯作者：
CATS, A
中科院分区：
文献类型：
--
作者：
HAZES, JMW;DIJKMANS, BAC;CATS, A
为了寻找与口服避孕药使用有关的行为方面，可能解释口服避孕药对类风湿性关节炎(RA)发病的有利影响，研究了吸烟和饮酒作为可能的危险因素。对135例确诊为新近确诊或典型类风湿性关节炎的年轻女性和378例对照的软组织风湿病或骨关节炎患者进行门诊初诊时的吸烟和饮酒情况的访谈。所有患者的诊断都通过至少两年的随访得到确认。在RA患者中，44/135(33%)现在吸烟，而对照组181/378(48%)。对照组中吸烟者的百分比与女性吸烟者在总人口中的百分比相似。每天至少吸烟一支的女性患类风湿关节炎的调整风险为0.61(95%可信区间为0.42至0.89)。31例(23%)RA患者和137例(36%)对照组为饮酒者。每天至少饮酒一次的女性患类风湿性关节炎的风险为0.52(95%CI为0.33~0.84)。吸烟和饮酒的低相对风险估计与口服避孕药的使用、人类白细胞抗原DR4的存在或RA阳性家族史无关。RA患者饮酒发生率低可能与发病后停止饮酒有关。吸烟在患者中的低发生率可能反映了吸烟对RA发病的保护作用，可能是通过改变免疫系统而引起的。
In a search for aspects of behaviour related to oral contraceptive use which might explain the favourable effect of oral contraception on the onset of rheumatoid arthritis (RA), cigarette smoking and alcohol consumption were studied as possible risk factors. Information on cigarette smoking and alcohol consumption was obtained by interview at the first visit to the outpatient clinic of 135 young women with confirmed definite or classical RA of recent onset and 378 control patients with soft tissue rheumatism or osteoarthritis. The diagnosis in all patients was confirmed by at least two years of follow up. Of the patients with RA, 44/135 (33%) were current cigarette smokers compared with 181/378 (48%) of the controls. The percentage of smokers among the controls was similar to that of women smokers in the general population. The adjusted risk of RA in women who smoked at least one cigarette a day was 0.61 (95% confidence interval (CI) 0.42 to 0.89). Thirty one (23%) patients with RA and 137 (36%) controls were alcohol drinkers. The risk of RA in women who consumed alcohol at least once a day was 0.52 (95% CI 0.33 to 0.84). The low relative risk estimates for cigarette smoking and alcohol consumption were mutally independent and also independent of oral contraceptive use, the presence of the HLA-DR4 antigen, or a positive family history of RA. The low incidence of alcohol consumption in the patients with RA might be due to the discontinuation of alcohol consumption after disease onset. The low incidence of cigarette smoking in the patients might reflect a protective effect of cigarette smoking on RA onset, possibly induced by changes in the immune system.