Mikuls Ted R, Sayles Harlan, Yu Fang, Levan Tricia, Gould Karen A, Thiele Geoffrey M, Conn Doyt L, Jonas Beth L, Callahan Leigh F, Smith Edwin, Brasington Richard, Moreland Larry W, Reynolds Richard J, Bridges S Louis
University of Nebraska Medical Center and Omaha Veterans Affairs Medical Center, Omaha, USA.
Arthritis Rheum. 2010 Dec;62(12):3560-8. doi: 10.1002/art.27716.
To examine the associations of cigarette smoking with rheumatoid arthritis (RA) in African Americans, and to determine whether this association is impacted by the HLA-DRB1 shared epitope (SE).
Smoking status, cumulative smoking exposure, and SE status were determined in African American patients with RA and African American healthy controls. Associations of smoking with RA were examined using age- and sex-adjusted logistic regression analyses. Additive and multiplicative SE-smoking interactions were examined.
After adjustment for age and sex, ever smoking (odds ratio [OR] 1.45, 95% confidence interval [95% CI] 1.07, 1.97) and current smoking (OR 1.56, 95% CI 1.07, 2.26), relative to never smoking, were more common in African American patients with RA (n = 605) than in controls (n = 255). The association of smoking with RA was limited to those with a cumulative exposure exceeding 10 pack-years, associations that were evident both in autoantibody-positive and in autoantibody-negative disease. There was evidence of a significant additive interaction between SE status and heavy smoking (≥10 pack-years) in relation to RA risk (attributable proportion [AP] due to interaction 0.58, P = 0.007), with similar results for the additive interaction between SE status and ever smoking (AP 0.47, P = 0.006). There was no evidence of multiplicative interactions.
Among African Americans, cigarette smoking is associated not only with the risk of autoantibody-positive RA but also with the risk of autoantibody-negative disease. The risk of RA attributable to smoking is limited to African Americans with more than 10 pack-years of exposure and is more pronounced among individuals positive for the HLA-DRB1 SE.
研究非裔美国人中吸烟与类风湿关节炎（RA）的关联，并确定这种关联是否受HLA - DRB1共享表位（SE）的影响。
确定非裔美国RA患者和非裔美国健康对照者的吸烟状况、累积吸烟暴露量和SE状态。使用年龄和性别调整的逻辑回归分析研究吸烟与RA的关联。研究SE - 吸烟的相加和相乘交互作用。
在调整年龄和性别后，曾经吸烟（比值比[OR] 1.45，95%置信区间[95%CI] 1.07，1.97）和当前吸烟（OR 1.56，95%CI 1.07，2.26），相对于从不吸烟，在非裔美国RA患者（n = 605）中比在对照者（n = 255）中更常见。吸烟与RA的关联仅限于累积暴露超过10包年的人群，这种关联在自身抗体阳性和自身抗体阴性疾病中均明显。有证据表明SE状态与大量吸烟（≥10包年）之间存在显著的相加交互作用，与RA风险相关（交互作用导致的归因比例[AP] 0.58，P = 0.007），SE状态与曾经吸烟之间的相加交互作用结果相似（AP 0.47，P = 0.006）。没有相乘交互作用的证据。
在非裔美国人中，吸烟不仅与自身抗体阳性RA的风险相关，还与自身抗体阴性疾病的风险相关。吸烟导致的RA风险仅限于暴露超过10包年的非裔美国人，并且在HLA - DRB1 SE阳性个体中更为明显。
