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Alcohol Consumption and Risk of Rheumatoid Arthritis in Women

女性饮酒与类风湿关节炎的风险

基本信息

批准号：
8151067
负责人：
Bing Lu
金额：
$ 8.58万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2013-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8151067
关键词：
Adult Affect Age Air Pollution Alcohol consumption Alcohols Alleles Alveolar Macrophages American Arthritis Autoimmune Diseases Blood Case-Control Studies Chronic Cigarette Classification Cohort Studies Data Data Set Development Disease Environmental Epidemiology Environmental Risk Factor Epidemiologic Studies Epitopes Etiology Exogenous Hormone Therapy Female Food Frequencies Funding Genes Genetic Genetic Risk Genotype HLA-DRB1 Hormones Human Human Genetics In Vitro Inflammatory Interleukin-6 Investigation Lead Measures Meta-Analysis Nurses Nurses&apos Health Study Participant Pathogenesis Patient Self-Report Population Predisposition Prevention strategy Prospective Studies Public Health Publishing Questionnaires Race Rare Diseases Reproductive History Rheumatism Rheumatoid Arthritis Rheumatoid Factor Rheumatology Risk Risk Reduction Running Sample Size Serological Smoking TNF gene Time United States Woman Women&apos s Health alcohol exposure alcohol risk base case control chemokine cigarette smoking cohort college cyclic citrullinated peptide cytokine epidemiology study genetic epidemiology genetic risk factor genome wide association study in vivo innovation insight interest lifestyle factors prospective protective effect public health relevance reproductive rheumatologist

项目摘要

DESCRIPTION (provided by applicant): The etiology of rheumatoid arthritis (RA), a chronic, destructive, debilitating arthritis that disproportionately affects women, remains incompletely understood. It is considered to be a multifactorial disease, resulting from the interaction of both genetic and environmental factors. Epidemiologic research has produced convincing data for strong environmental risk factors, including cigarette smoking, exogenous hormone use and female reproductive factors. Recently, advances in human genetics have identified 22 risk alleles associated with RA. Alcohol use, as an important lifestyle factor, has been associated with reduced risk of RA based on previous case-control studies. However, most case-control studies which ascertained alcohol exposure retrospectively were limited by the recall bias. The only prospective cohort study on alcohol and RA was limited by small number of cases, and used a one time self-reported alcohol measure that may induce misclassification bias of exposure status. Thus well-controlled prospective cohort studies with larger sample size and more accurate alcohol measures are needed. The Nurses' Health Studies (NHS) are among the largest and longest running investigations of factors that influence women's health in the World. Started in 1976 and expanded in 1989, the information provided by the 238,000 dedicated nurse-participants has provided the unique opportunity to study rare diseases such as RA. We propose the following specific aims based on existing NHS data: 1) To investigate the association between alcohol consumption and the development of RA in women after controlling for age, race, cigarette smoking, reproductive factors and exogenous hormone use using entire NHS cohorts. All RA incident cases were confirmed by 2 board-certified rheumatologists according to American College of Rheumatology classification criteria. Alcohol consumption was assessed repeatedly within a semi-quantitative food frequency questionnaire started from 1980 in NHS 1 and 1989 in NHS II to the last cycle of the questionnaire for non-cases and before RA onset for cases. We will use cumulative average alcohol consumption across repeated measures instead of one-time measure to best represent long-term alcohol consumption. 2) To investigate interactions between 22 identified genetic risk alleles for RA and alcohol consumption using a matched case-control subsample with genotyping (500 incident RA cases, 500 matched controls) nested in NHS cohorts. These innovative studies will advance understanding of RA etiology and furnish additional information for RA prevention strategies, and provide potential public health implications how a modifiable lifestyle factor may influence the risk of developing RA. PUBLIC HEALTH RELEVANCE: Alcohol use as an important lifestyle factor may be associated with decreased risk of RA. However, definitive data supporting this association from well-controlled prospective studies are lacking. Findings from this large cohort study will clarify the possible protective effect of alcohol use on risk of RA in women and furnish additional information for RA prevention strategies.

描述(由申请人提供)：类风湿性关节炎(RA)是一种慢性、破坏性、衰弱的关节炎，对女性的影响不成比例，目前仍不完全清楚。它被认为是一种多因素疾病，是遗传和环境因素共同作用的结果。流行病学研究已经为强烈的环境风险因素提供了令人信服的数据，包括吸烟、外源性激素使用和女性生殖因素。最近，人类遗传学研究发现了22个与类风湿关节炎相关的危险等位基因。根据先前的病例对照研究，饮酒作为一种重要的生活方式因素，与RA风险的降低有关。然而，大多数回溯确定酒精暴露的病例对照研究都受到回忆偏差的限制。关于酒精和类风湿性关节炎的唯一前瞻性队列研究受限于少数病例，并且使用一次性自我报告的酒精测量，这可能会导致对暴露状态的错误分类偏差。因此，需要更大样本量和更准确酒精测量的良好控制的前瞻性队列研究。护士健康研究(NHS)是世界上对影响女性健康的因素进行的规模最大、持续时间最长的调查之一。从1976年开始，并在扩展，由238,000名敬业的护士参与者提供的信息为研究罕见疾病提供了独特的机会，如RA。基于NHS现有的数据，我们提出了以下具体目标：1)在使用整个NHS队列控制了年龄、种族、吸烟、生殖因素和外源性激素使用后，调查饮酒与女性RA发生之间的关联。根据美国风湿病学会的分类标准，所有的类风湿性关节炎病例均由2名委员会认证的风湿科医生确认。在从1980年NHS 1和NHS II 1989年开始的半定量食物频率问卷中反复评估饮酒情况，直到问卷的最后一个周期(非病例)和RA发病前(病例)。我们将使用重复测量的累计平均酒精消耗量，而不是一次性测量来最好地代表长期酒精消费。2)使用NHS队列中嵌套的配对病例对照亚样本(500例RA发病病例和500例匹配对照)，研究22个已识别的RA遗传风险等位基因与饮酒之间的交互作用。这些创新性的研究将促进对RA病因的理解，并为RA预防策略提供更多信息，并提供潜在的公共卫生影响，即可改变的生活方式因素如何影响发生RA的风险。公共卫生相关性：饮酒作为一个重要的生活方式因素，可能与RA风险降低有关。然而，从控制良好的前瞻性研究中缺乏明确的数据来支持这种联系。这项大型队列研究的结果将阐明饮酒对女性类风湿性关节炎风险的可能保护作用，并为类风湿性关节炎预防策略提供更多信息。