Environmental risk factors differ between rheumatoid arthritis with and without auto-antibodies against cyclic citrullinated peptidesReport as inadecuate




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Arthritis Research and Therapy

, 8:R133

First Online: 27 July 2006Received: 04 March 2006Revised: 11 July 2006Accepted: 27 July 2006

Abstract

The aim of this study was to evaluate new and previously hypothesised non-genetic risk factors for serologic subtypes of rheumatoid arthritis RA defined by the presence or absence of auto-antibodies to cyclic citrullinated peptides CCP. In a national case-control study, we included 515 patients recently diagnosed with RA according to the American College of Rheumatology 1987 classification criteria and 769 gender- and age-matched population controls. Telephone interviews provided information about non-genetic exposures, and serum samples for patients were tested for anti-CCP-antibodies. Associations between exposure variables and risk of anti-CCP-positive and anti-CCP-negative RA were evaluated using logistic regression. A series of RA subtype-specific risk factors were identified. Tobacco smoking odds ratio OR = 1.65; 95% confidence interval: 1.03–2.64, for >20 versus 0 pack-years was selectively associated with risk of anti-CCP-positive RA, whereas alcohol consumption exhibited an inverse dose-response association with this RA subtype OR = 1.98, 1.22–3.19, for 0 versus >0–5 drinks per week. Furthermore, coffee consumption OR = 2.18; 1.07–4.42, for >10 versus 0 cups per day, ever use of oral contraceptives OR = 1.65; 1.06–2.57 and having a first-degree relative with schizophrenia OR = 4.18; 1.54–11.3 appeared more strongly associated with risk of anti-CCP-positive RA. Obesity was selectively associated with risk of anti-CCP-negative RA, with obese individuals being at more than 3-fold increased risk of this subtype compared with normal-weight individuals OR = 3.45; 1.73–6.87. Age at menarche was the only examined factor that was significantly associated with both serologic subtypes of RA p-trends = 0.01; women with menarche at age ≥ 15 years had about twice the risk of either RA subtype compared with women with menarche at age ≤ 12 years. Major differences in risk factor profiles suggest distinct etiologies for anti-CCP-positive and anti-CCP-negative RA.

AbbreviationsACRAmerican College of Rheumatology

CCPcyclic citrullinated peptide

CIconfidence interval

ELISAenzyme-linked immunosorbent assay

Igimmunoglobulin

ORodds ratio

RArheumatoid arthritis

RFrheumatoid factor

VCAviral capsid antigen.

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Author: Merete Pedersen - Søren Jacobsen - Mette Klarlund - Bo V Pedersen - Allan Wiik - Jan Wohlfahrt - Morten Frisch

Source: https://link.springer.com/



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