Abstract
Alcohol consumption may be associated with the risk of rheumatoid arthritis (RA), but potential sex-related differences in this association have not been explored. Thus, we utilized 87,118 participants in the Kailuan Study, a prospective cohort initiated in 2006 to study the risk factors of cardiovascular disease in a Chinese population. We included those that did not have RA at baseline (2006), and performed cox proportional hazard modeling to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) of RA according to the levels of alcohol consumption (never or past, light or moderate (<1 serving/day for women, <2 servings/day for men), and heavy (>1 serving/day for women, >2 servings/day for men), adjusting for age, sex, body mass index, and smoking. Diagnoses of RA were confirmed via medical record review by rheumatologists. From 2006 to 2018, we identified 87 incident RA cases. After adjusting for potential confounders, the HR of RA was 1.26 (95% CI: 0.62, 2.56) for participants with light or moderate alcohol consumption and 1.98 (95% CI: 0.93, 4.22) for participants with heavy alcohol consumption) versus non-drinkers. The HR of each 10 g increase in alcohol consumption was 1.11 (95% CI: 0.98, 1.26) (p-trend = 0.09). A significant association between alcohol consumption and RA risk was observed in women, but not in men (p for interaction = 0.06). Among women, each 10 g increase in alcohol consumption was significantly associated with a high risk of RA (HR: 1.56; 95% CI: 1.06, 2.29). In contrast, each 10 g increase in alcohol consumption was not significantly associated with the risk of RA in men (HR: 1.10; 95% CI: 0.97, 1.25). Excluding past drinkers generated similar results. In this prospective Chinese cohort, increasing alcohol consumption was associated with an elevated risk of RA among women, but not in men. These findings highlight the importance of incorporating analysis of sex differences into future studies of alcohol consumption and RA risk.
Highlights
We investigated whether body mass index (BMI) (27.5 kg/m2 ), smoking, highsensitivity c-reactive protein (hs-CRP), LDL-c, HDL-c, triglycerides, or total cholesterol affected the association between alcohol consumption and rheumatoid arthritis (RA) risk using the likelihood ratio test, adjusting for the previously mentioned covariates
Alcohol consumption was associated with current smoking, presence of hypertension, high concentrations of triglycerides, LDL-cholesterol, and HDL-cholesterol (Table 1)
Prospective cohortBMI, study, we demonstrated that irrespective of smoking alcohol and smoking, hs-CRP, LDL-c, HDL-c, triglycerides, or total status and in other potential risk factors for RA, alcohol was associated with a cholesterol relation to RA
Summary
60% of the risk of rheumatoid arthritis (RA) can be attributed to genetic factors [1,2], but environmental and lifestyle risk factors for RA have been identified, such as smoking and silica dust exposure [3,4]. A previous meta-analysis based on eight prospective studies suggested that the impact of alcohol consumption on RA risk might follow a J-shaped curve, and people with low-to-moderate alcohol consumption may have a lower RA risk, relative to non- and heavy-drinkers [5]. This analysis did not separate past drinkers from never drinkers, which may have impacted the results. There may be an interaction that has not been fully explored, such as between alcohol consumption and other factors (e.g., sex), that may affect the association between alcohol consumption and RA risk [6,7,8]
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