Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a dose-response meta-analysis of prospective studies

Jin, Zhichao; Xiang, Chun; Cai, Qing; Wei, Xin; He, Jia

doi:10.1136/annrheumdis-2013-203323

Cited by 106 publications

(93 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is inconsistent with recently published meta-analyses [11,12]. One reason to this discrepancy could be that the consumption of alcohol in these patients and controls was lower than in studies showing associations [20,21] and may, therefore, mask a significant association due to a lack of individuals reaching critical levels for the protective effect of alcohol.…”

Section: Discussioncontrasting

confidence: 71%

“…Although studies have suggested associations, mainly regarding fruit, vegetables, meat and disease development, the results have been inconclusive [4][5][6][7][8][9][10]. Regarding the consumption of alcohol, recently published meta-analyses concluded that moderate consumption of alcohol intake is inversely associated with the development of RA [11,12].…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Diet and alcohol as risk factors for rheumatoid arthritis: a nested case–control study

2014

View full text Add to dashboard Cite

The aim of this study was to investigate whether alcohol and diet, assessed as both macronutrients and dietary patterns, increased the risk of development of rheumatoid arthritis (RA) through a nested case-control design in the Västerbotten Intervention Program (VIP) cohort. Individuals in the VIP who had developed RA after the dietary survey were identified from medical records at the department of rheumatology at the University Hospital, Umeå (n = 386), and matched to 1,886 controls from the same database. Diet was assessed as food groups, as macronutrients and as scores of dietary patterns, namely the carbohydrate-restricted diet score, the Mediterranean diet score and the healthy diet indicator score. When analysing the dietary patterns, consumption of food groups and different macronutrients, a significant association was found in the highest tertile of carbohydrate-restricted diet among the cases with a subsequent anti-CCP-positive disease 1.40 (1.02-1.92), as well as in the highest tertile of protein consumption among smokers (OR = 1.80, 95% CI 1.09-2.95). However, after additional adjustment for sodium intake, these associations were no longer statistically significant. No association was observed between alcohol consumption and the risk of RA. To summarize, there were no significant associations between diet, or alcohol consumption, and the risk of development of RA within this cohort. The lack of any significant associations of alcohol consumption may be explained by a low consumption in the studied population overall or alternatively by methodological issues raised recently.

show abstract

Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 98%

Diet and alcohol as risk factors for rheumatoid arthritis: a nested case–control study

2014

View full text Add to dashboard Cite

show abstract

“…Furthermore, in multiple epidemiologic studies and including studies where data regarding alcohol intake was collected prior to incident RA, modest alcohol consumption (in some studies 1–2 drinks daily) has been associated with decreased risk for RA (97–101), although not invariably (98). There have also been mixed results of the protective effect of alcohol in longitudinal studies of individuals who have presented to clinical care with musculoskeletal symptoms in absence of IA on examination at baseline.…”

Section: Environmental Risk Factors For Ramentioning

confidence: 99%

Genetic and environmental risk factors for rheumatoid arthritis

Deane

Demoruelle

Kelmenson

et al. 2017

Best Practice & Research Clinical Rheumatology

470

296

View full text Add to dashboard Cite

Multiple genetic and environmental factors have been associated with an increased risk for rheumatoid arthritis (RA). Of these, the strongest associations have been seen with female sex, a family history of RA, the genetic factor the ‘shared epitope’ and with exposure to tobacco smoke. There is also renewed interest in mucosal inflammation and microbial factors as contributors to the development of RA. However, the identification of a ‘preclinical’ period of RA that can be defined as local or systemic autoimmunity as measured by autoantibodies and other biomarkers prior to the development of clinically-apparent synovitis suggests that the risk factors for RA are acting long prior to first clinical evidence of IA. As such, a major challenge to the field will be to investigate the full spectrum of the development of RA, from initiation and propagation of autoimmunity during preclinical RA and transition to clinically-apparent synovitis and classifiable RA, in order to determine which genetic and environmental factors are important at each stage of disease development. Understanding the exact role and timing of action of risk factors for RA is especially important given the advent of prevention trials in RA, and the hope that a full understanding of genetic and environmental factors in RA could lead to effective preventive interventions.

show abstract

“…First, a major limitation of our meta-analysis of observational studies was the possibility of uncontrolled confounding. Although major potential confounders had been adjusted for in most included studies, residual or unknown confounding cannot be excluded (Aune et al, 2011;Jin et al, 2013). For instance, the exposure potential in underground miners has been described as complex, with multiple carcinogenic occupational exposures.…”

Section: Limitations Of the Meta-analysismentioning

confidence: 98%

Nonlinear dose–response relationship between radon exposure and the risk of lung cancer

Duan

Quan

et al. 2015

European Journal of Cancer Prevention

View full text Add to dashboard Cite

Although radon exposure (RE) has been confirmed to increase the risk of lung cancer (LC), questions remain about the shape of the dose-response relationship between RE and the risk of LC. We carried out a dose-response meta-analysis to investigate and quantify the potential dose-response association between residential and occupational exposure to radon and the risk of LC. All cohort and case-control studies published in English and Chinese on Embase, PubMed, and China National Knowledge Infrastructure (CNKI) digital databases through November 2013 were identified systematically. We extracted effect measures (relative risk, odds ratio, standardized mortality ratio, standardized incidence ratio, or standardized rate ratio) from individual studies to generate pooled results using meta-analysis approaches. We derived meta-analytic estimates using random-effects models taking into account the correlation between estimates. Restricted cubic splines and generalized least-squares regression methods were used to model a potential curvilinear relationship and to carry out a dose-response meta-analysis. Stratified analysis, sensitivity analysis, and assessment of bias were performed in our meta-analysis. Sixty publications fulfilling the inclusion criteria for this meta-analysis were finally included. Occupational RE was associated with LC [risk ratio 1.86, 95% confidence interval (CI)=1.67-2.09; I²=92.2%; 27 prospective studies], for pooled risk estimate of the: standardized mortality ratio [2.00 (95% CI=1.82-2.32)]; standardized incidence ratio [1.45 (95% CI=1.20-1.74)]; relative risk [2.10 (95% CI=1.64-2.69)]. In a subgroup analysis of uranium miners and residents exposed to occupational uranium, the summary risk was 2.23 (95% CI=1.86-2.68) and 1.23 (95% CI=1.05-1.44). The overall meta-analysis showed evidence of a nonlinear association between RE and the risk of LC (P(nonlinearity)<0.014); in addition, the point value of residential radon also improved the results quantitatively, where odds ratios were 1.11 (95% CI=1.07-1.15) and 1.21 (95% CI=1.14-1.29) when the radon concentration was at the point of 100 and 200 Bq/m³ compared with the lowest. For 17 prospective studies with at least three categories of occupational cumulative radon dose, the dose-risk model estimated a risk ratio of 1.26 (95% CI=1.21-1.30) for 100 working level months and 1.51 (95% CI=1.38-1.65) for 200 working level months, respectively. The assessment of risk of bias within individual studies and across studies indicated risk that was unlikely to alter these results markedly. This meta-analysis shows a nonlinear dose-response association between environmental RE and the risk of LC. This increased risk is particularly apparent when the cumulative exposure to radon is well beyond that resulting from exposure to the recommended limit concentration for a prolonged period of time.

show abstract

Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a dose-response meta-analysis of prospective studies

Abstract: Low to moderate alcohol consumption inversely associated with the development of RA in a manner that appears to be dose-dependent, time-dependent and sex-dependent. Large prospective studies that investigate gene-environment interactions are required to further clarify the aetiology of RA.

Cited by 106 publications

References 31 publications

Diet and alcohol as risk factors for rheumatoid arthritis: a nested case–control study

Diet and alcohol as risk factors for rheumatoid arthritis: a nested case–control study

Genetic and environmental risk factors for rheumatoid arthritis

Nonlinear dose–response relationship between radon exposure and the risk of lung cancer

Contact Info

Product

Resources

About