The Centre for Arthritis and Rheumatic Disease, St Vincent's University Hospital, Dublin, Ireland.
Rheumatology, Lady Reading Hospital, Peshawar, Pakistan.
RMD Open. 2021 Apr;7(2). doi: 10.1136/rmdopen-2020-001510.
The role of alcohol in inflammatory disease remains debated. This study explores the relationship between alcohol and disease activity in patients with inflammatory arthritis.
Patients attending a rheumatology clinic between 2010 and 2020 were prospectively followed. Information on demographics, alcohol use, smoking habits and disease outcome measures were collected from these patients. Statistical analysis included univariate and multivariate linear and binary logistic regressions, Mann-Whitney U tests and one-way analysis of variance with Tukey's honest significant difference (HSD) test.
Of the 979 analysed patients, 62% had rheumatoid arthritis (RA), 26.7% had psoriatic arthritis (PsA) and 11.2% had ankylosing spondylitis. Mean DAS28-CRP (Disease Activity Score 28 - C-reactive protein) in RA and PsA at 1 year was 2.96±1.39, and 64.2% of patients were in remission (DAS28-CRP ≤2.6 or BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) ≤4). Both male gender and risky drinking (>15 units of weekly alcohol) were significantly associated with remission. Compared with women, men had an OR of 1.8 (1.1, 2.5) (p=0.034) for any alcohol consumption and 6.9 (4.7, 9.1) (p=0.001) for drinking at least 15 weekly drinks. When adjusted for gender, there was no association between alcohol and disease activity. Yet, when adjusted for alcohol consumption, gender still significantly influenced disease activity.
While it may appear that alcohol is linked to remission in inflammatory arthritis, when adjusted for gender, it is not. Men with inflammatory arthritis drink significantly more than women and have less severe disease activity.
酒精在炎症性疾病中的作用仍存在争议。本研究探讨了炎症性关节炎患者中酒精与疾病活动度的关系。
前瞻性随访 2010 年至 2020 年间在风湿病诊所就诊的患者。从这些患者中收集人口统计学、酒精使用、吸烟习惯和疾病结局测量的信息。统计分析包括单变量和多变量线性和二项逻辑回归、Mann-Whitney U 检验和单向方差分析，采用 Tukey 的诚实显著差异（HSD）检验。
在分析的 979 名患者中，62%患有类风湿关节炎（RA），26.7%患有银屑病关节炎（PsA），11.2%患有强直性脊柱炎。RA 和 PsA 患者在 1 年内的平均 DAS28-CRP（Disease Activity Score 28 - C-reactive protein）为 2.96±1.39，64.2%的患者处于缓解状态（DAS28-CRP≤2.6 或 BASDAI[Bath 强直性脊柱炎疾病活动指数]≤4）。男性和高风险饮酒（>15 单位每周饮酒）与缓解显著相关。与女性相比，男性任何饮酒的 OR 为 1.8（1.1，2.5）（p=0.034），每周饮酒至少 15 杯的 OR 为 6.9（4.7，9.1）（p=0.001）。在调整性别后，酒精与疾病活动度之间没有关联。然而，在调整饮酒量后，性别仍然显著影响疾病活动度。
虽然酒精与炎症性关节炎的缓解似乎有关联，但在调整性别后，并非如此。患有炎症性关节炎的男性饮酒量明显多于女性，且疾病活动度较轻。
