Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis Rheumatol. 2014 Aug;66(8):1998-2005. doi: 10.1002/art.38634.
To evaluate the association of alcohol consumption with the risk of rheumatoid arthritis (RA) in 2 large prospective cohorts, the Nurses' Health Study (NHS) and NHSII.
The NHS was established in 1976 and enrolled 121,701 female registered nurses in the US. The NHSII began in 1989, enrolling 116,430 female nurses. Lifestyle and environmental exposures were collected through biennial questionnaires. Alcohol consumption was assessed with a food frequency questionnaire, which was completed every 4 years. Incident RA cases were identified using a connective tissue disease screening questionnaire and a medical record review. Separate Cox proportional hazards models were used to estimate hazard ratios (HRs) after adjusting for potential confounders in the NHS and NHSII. The pooled HR from 2 cohorts was estimated using a DerSimonian and Laird random-effects model.
Among 1.90 million person-years from 1980 to 2008, 580 incident cases of RA were diagnosed in the NHS cohort, and among 1.78 million person-years from 1989 to 2009, 323 incident cases of RA were diagnosed in the NHSII cohort. Compared to no use, the pooled multivariable adjusted HR for alcohol use of 5.0-9.9 gm/day was 0.78 (95% confidence interval [95% CI] 0.61-1.00). For seropositive RA cases, the association appeared stronger (HR 0.69 [95% CI 0.50-0.95]). In addition, women who drank beer 2-4 times a week had a 31% decreased risk compared to women who never drank beer.
We found a modest association between long-term moderate alcohol drinking and reduced risk of RA. Future studies are needed to confirm our findings in other populations.
在两项大型前瞻性队列研究，即护士健康研究（NHS）和 NHSII 中，评估饮酒与类风湿关节炎（RA）风险的相关性。
NHS 于 1976 年成立，纳入了美国 121701 名注册护士。NHSII 于 1989 年开始，纳入了 116430 名女护士。通过每两年一次的问卷收集生活方式和环境暴露情况。通过食物频率问卷评估饮酒情况，每 4 年完成一次。通过结缔组织疾病筛查问卷和病历回顾来确定 RA 发病病例。在 NHS 和 NHSII 中，使用单独的 Cox 比例风险模型调整潜在混杂因素后，估计风险比（HR）。使用 DerSimonian 和 Laird 随机效应模型对来自两个队列的汇总 HR 进行估计。
在 1980 年至 2008 年的 190 万个人年中，NHS 队列中诊断出 580 例 RA 发病病例，在 1989 年至 2009 年的 178 万个人年中，NHSII 队列中诊断出 323 例 RA 发病病例。与不饮酒相比，酒精摄入量为 5.0-9.9 gm/天的多变量调整后的汇总 HR 为 0.78（95%置信区间 [95%CI] 0.61-1.00）。对于血清阳性 RA 病例，相关性似乎更强（HR 0.69 [95%CI 0.50-0.95]）。此外，与从不喝啤酒的女性相比，每周喝啤酒 2-4 次的女性患 RA 的风险降低了 31%。
我们发现长期适度饮酒与 RA 风险降低之间存在适度关联。需要进一步的研究来确认我们在其他人群中的发现。
