Hazes J M, Dijkmans B A, Vandenbroucke J P, de Vries R R, Cats A
Department of Rheumatology, University Hospital, Leiden, The Netherlands.
Ann Rheum Dis. 1990 Dec;49(12):980-2. doi: 10.1136/ard.49.12.980.
In a search for aspects of behaviour related to oral contraceptive use which might explain the favourable effect of oral contraception on the onset of rheumatoid arthritis (RA), cigarette smoking and alcohol consumption were studied as possible risk factors. Information on cigarette smoking and alcohol consumption was obtained by interview at the first visit to the outpatient clinic of 135 young women with confirmed definite or classical RA of recent onset and 378 control patients with soft tissue rheumatism or osteoarthritis. The diagnosis in all patients was confirmed by at least two years of follow up. Of the patients with RA, 44/135 (33%) were current cigarette smokers compared with 181/378 (48%) of the controls. The percentage of smokers among the controls was similar to that of women smokers in the general population. The adjusted risk of RA in women who smoked at least one cigarette a day was 0.61 (95% confidence interval (CI) 0.42 to 0.89). Thirty one (23%) patients with RA and 137 (36%) controls were alcohol drinkers. The risk of RA in women who consumed alcohol at least once a day was 0.52 (95% CI 0.33 to 0.84). The low relative risk estimates for cigarette smoking and alcohol consumption were mutually independent and also independent of oral contraceptive use, the presence of the HLA-DR4 antigen, or a positive family history of RA. The low incidence of alcohol consumption in the patients with RA might be due to the discontinuation of alcohol consumption after disease onset. The low incidence of cigarette smoking in the patients might reflect a protective effect of cigarette smoking on RA onset, possibly induced by changes in the immune system.
为探寻与口服避孕药使用相关的行为因素，以解释口服避孕药对类风湿关节炎（RA）发病的有利影响，对吸烟和饮酒作为可能的风险因素进行了研究。通过对135名近期确诊为明确或典型RA的年轻女性门诊首诊患者以及378名软组织风湿病或骨关节炎对照患者进行访谈，获取了吸烟和饮酒的信息。所有患者的诊断均经至少两年的随访确认。RA患者中，44/135（33%）为当前吸烟者，而对照患者中这一比例为181/378（48%）。对照患者中的吸烟者比例与一般人群中的女性吸烟者比例相似。每天至少吸一支烟的女性患RA的校正风险为0.61（95%置信区间（CI）0.42至0.89）。31名（23%）RA患者和137名（36%）对照患者饮酒。每天至少饮酒一次的女性患RA的风险为0.52（95%CI 0.33至0.84）。吸烟和饮酒的低相对风险估计相互独立，也独立于口服避孕药的使用、HLA - DR4抗原的存在或RA的阳性家族史。RA患者中饮酒发生率低可能是由于发病后停止饮酒。患者中吸烟率低可能反映了吸烟对RA发病的保护作用，可能是由免疫系统变化引起的。
