Effect of Smoking on Remission Proportions Differs Between Male and Female Patients with Rheumatoid Arthritis: A Study Based on the IORRA Survey
Effect of Smoking on Remission Proportions Differs Between Male and Female Patients with Rheumatoid Arthritis: A Study Based on the IORRA Survey
复制标题
DOI：
10.3899/jrheum.140376
复制
发表时间：
2015-07-01
影响因子：
3.9
通讯作者：
Yamanaka, Hisashi
中科院分区：
文献类型：
--
作者：
Inoue, Yasushi;Nakajima, Ayako;Yamanaka, Hisashi
客观的。分析吸烟对类风湿性关节炎（RA）患者缓解比例影响的性别差异。方法。受试者是参加 2011 年 4 月进行的 IORRA 调查并报告吸烟状况的日本 RA 患者。对按性别和吸烟状况分层的受试者之间的临床特征、治疗状态和达到缓解的百分比进行比较。为了确认性别和吸烟状况对缓解的差异影响，我们使用了多变量逻辑回归模型，因变量为 28 关节疾病活动评分 (DAS28) 缓解。结果。在 810 名男性和 4206 名女性中，分别有 162 名（20.0%）和 3173 名（75.4%）从不吸烟；目前吸烟者分别为 208 人 (25.7%) 和 314 人 (7.5%)。在男性中，从不吸烟的人往往比过去和现在吸烟的人有更高的缓解比例。相比之下，吸烟状况似乎并不影响女性的病情缓解。除了男性从不吸烟者的皮质类固醇剂量较低外，在比较治疗状态方面没有观察到显着差异。通过多变量分析，与从不吸烟的男性相比，过去和现在吸烟的男性与 DAS28 红细胞沉降率缓解呈负相关[OR 分别为 0.66 和 0.61，95% CI (0.44-0.98) 和 (0.39-0.96)]。然而，与从不吸烟的女性相比，过去和现在吸烟的女性与缓解无关[OR 分别为 1.04 和 1.19，95% CI (0.86-1.25) 和 (0.91-1.54)]。结论。我们证明吸烟对男性和女性缓解比例的影响不同。我们的研究结果表明，在为 RA 患者制定治疗策略时，性别和吸烟状况都是重要的考虑因素。
Objective. To analyze sex difference in the effect of smoking on remission proportions in patients with rheumatoid arthritis (RA).Methods. Subjects were Japanese patients with RA who participated in the IORRA survey conducted in April 2011 and reported smoking status. Clinical characteristics, treatment status, and the percentages achieving remission were compared between subjects stratified by sex and smoking status. To confirm the differential effects of sex and smoking status on remission, we used multivariate logistic regression models with the dependent variable as 28-joint Disease Activity Score (DAS28) remission.Results. Among 810 men and 4206 women, 162 (20.0%) and 3173 (75.4%), respectively, were never smokers; 208 (25.7%) and 314 (7.5%), respectively, were current smokers. In men, never smokers tended to have higher remission proportions than past and current smokers. In contrast, smoking status seemed not to affect remission in women. Except for lower corticosteroid dose in male never smokers, no significant differences were observed in comparing treatment status. By multivariate analyses, male past and current smokers were negatively associated with DAS28-erythrocyte sedimentation rate remission compared to male never smokers [OR 0.66 and 0.61, 95% CI (0.44-0.98) and (0.39-0.96), respectively]. However, female past and current smokers were not associated with remission compared to female never smokers [OR 1.04 and 1.19, 95% CI (0.86-1.25) and (0.91-1.54), respectively].Conclusion. We demonstrated that the effect of smoking on remission proportions differed between men and women. Our findings suggest that both sex and smoking status are important considerations when planning a treatment strategy for patients with RA.