Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Health Research Methodology Department, McMaster University, Hamilton, Canada.
Rheumatol Int. 2021 Apr;41(4):699-705. doi: 10.1007/s00296-021-04791-w. Epub 2021 Feb 24.
To study the association of smoking status and the level of seropositivity in RA patients from COMORA Cohort. A post hoc analysis of COMORA database included 3439 RA patients was performed. Current smokers or recently quitted (< 3 years) were initially compared to those who never smoked or stopped > 3 years (Group I vs. II) regarding their seropositivity status (high positive, low positive and negative) for Rheumatoid Factor (RF) or Anti-citrullinated antibodies (ACPA). A further comparison was made between current smokers (Group III) and never smoked patients (Group IV). Analysis was also done on the individual country level for the 17 countries included in the COMORA study. Out of 3439 RA patients, 705 (20.5%) were smokers (group I), and 2734 (79.5%) were non-smokers (group II). Significantly more patients in group I, 442 (62.7%), had high levels of seropositivity than those in group II, 1556 (56.9%), [P = 0.006, OR 1.27 (95% CI, 1.07-1.5)]. More current smoker patients (group III-286 out of 456 "62.7%") had high levels of seropositivity than never smoked patients (group IV-1236 out of 2191 "56.4%"), with significant difference [P = 0.013, OR 1.3 (95% CI, 1.06-1.6)]. In 11 countries, higher proportions of patients with high level of seropositivity in group I was found, with statistical significance in four countries. Smoking was associated with higher level of seropositivity in patients with RA in this post hoc analysis, both on a global level and in certain individual countries. As smoking is a modifiable risk factor, studying the effects of quitting smoking on level of seropositivity and other disease parameters is warranted.
为了研究 COMORA 队列中吸烟状况与 RA 患者血清阳性率之间的关联，对 COMORA 数据库进行了一项事后分析，该分析纳入了 3439 例 RA 患者。比较了当前吸烟者或近期戒烟（<3 年）者（I 组）与从不吸烟者或戒烟>3 年者（II 组）的血清学阳性状态（RF 或 ACPA 高阳性、低阳性和阴性）。比较了当前吸烟者（III 组）与从不吸烟者（IV 组）之间的差异。还对 COMORA 研究中纳入的 17 个国家进行了个体国家层面的分析。在 3439 例 RA 患者中，705 例（20.5%）为吸烟者（I 组），2734 例（79.5%）为非吸烟者（II 组）。I 组中，442 例（62.7%）患者血清学阳性率较高，高于 II 组的 1556 例（56.9%），[P=0.006，OR 1.27（95%CI，1.07-1.5）]。与从不吸烟者（2191 例中的 1236 例，56.4%）相比，更多的当前吸烟者（456 例中的 286 例，62.7%）具有高滴度的血清阳性，差异具有统计学意义[P=0.013，OR 1.3（95%CI，1.06-1.6）]。在 11 个国家中，I 组中高滴度血清阳性率的患者比例较高，其中 4 个国家有统计学意义。在这项事后分析中，吸烟与 RA 患者的高滴度血清阳性率相关，无论是在全球水平还是在某些个别国家。由于吸烟是一个可改变的危险因素，研究戒烟对血清阳性率和其他疾病参数的影响是有必要的。
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