Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, South Korea.
Department of Family Medicine and Supportive Care Centre, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Sci Rep. 2020 Nov 27;10(1):20793. doi: 10.1038/s41598-020-77841-1.
In previous literature regarding development of rheumatoid arthritis (RA), female reproductive factors have been described as protective factors, risk factors, or irrelevant, leading to inconsistent results. The aim of this study was to investigate the effect of female reproductive factors on the incidence of seropositive RA. A large population-based retrospective cohort of the National Health Insurance Service data in South Korea was used. Postmenopausal women who participated in both cardiovascular and breast cancer screening in 2009 were included and followed until date of seropositive RA diagnosis, death, or December 31, 2018. Multivariable-adjusted Cox proportional hazards model was used to assess the association between reproductive factors and incident seropositive RA. Of 1,357,736 postmenopausal women, 6056 women were diagnosed with seropositive RA, and the incidence rate was 54.16 cases/100,000 person-years. Reproductive factors other than hormone replacement therapy (HRT) were not significantly associated with seropositive RA incidence. Postmenopausal women who used HRT ≥ 5 years were associated with a higher aHR of incident seropositive RA than never-users (aHR 1.25; 95% CI 1.09-1.44). Alcohol consumption less than 30 g per day (aHR 0.80; 95% CI 0.74-0.87), regular physical activity (aHR 0.90; 95% CI 0.84-0.97), diabetes mellitus (aHR 0.85; 95% CI 0.78-0.93), and cancer (aHR 0.77; 95% CI 0.64-0.92) were associated with lower risk of seropositive RA. Most female reproductive factors did not significantly affect the development of seropositive RA in postmenopausal women. Only HRT is associated with a small but significant increase in risk of seropositive RA.
在之前关于类风湿关节炎（RA）发病机制的文献中，女性生殖因素被描述为保护因素、风险因素或无关因素，导致结果不一致。本研究旨在探讨女性生殖因素对血清阳性 RA 发病的影响。该研究使用了韩国国家健康保险服务的大型基于人群的回顾性队列数据。纳入了 2009 年参加过心血管和乳腺癌筛查的绝经后女性，并随访至血清阳性 RA 诊断、死亡或 2018 年 12 月 31 日。多变量调整的 Cox 比例风险模型用于评估生殖因素与血清阳性 RA 发病的相关性。在 1357736 名绝经后女性中，有 6056 名女性被诊断为血清阳性 RA，发病率为 54.16 例/100000 人年。除激素替代疗法（HRT）外，其他生殖因素与血清阳性 RA 发病率无显著相关性。使用 HRT ≥5 年的绝经后女性发生血清阳性 RA 的校正后风险比（aHR）高于从未使用者（aHR 1.25；95%CI 1.09-1.44）。每天饮酒量<30g（aHR 0.80；95%CI 0.74-0.87）、有规律的体育活动（aHR 0.90；95%CI 0.84-0.97）、糖尿病（aHR 0.85；95%CI 0.78-0.93）和癌症（aHR 0.77；95%CI 0.64-0.92）与血清阳性 RA 发病风险降低相关。大多数女性生殖因素与绝经后女性血清阳性 RA 的发生无显著相关性。只有 HRT 与血清阳性 RA 的发病风险略有增加相关。
