Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Marshfield Clinic Research Institute, Center for Clinical Epidemiology and Population Health, Marshfield, WI, USA.
Scand J Rheumatol. 2022 Mar;51(2):97-101. doi: 10.1080/03009742.2021.1925584. Epub 2021 Jun 25.
The objective of this medical record review study is to define the association between smoking and Sjӧgren's syndrome (SS) in a large rheumatoid arthritis (RA) cohort.
Electronic health records from a population-based cohort were screened for RA eligibility between 2005 and 2018. Inclusion criteria were age ≥ 18 years, two or more RA diagnoses, including two diagnoses by a rheumatologist, or positive rheumatoid factor or anti-cyclic citrullinated peptide (anti-CCP) antibody. The independent variable, smoking status, was defined as never, current, or past. The outcome, SS, was defined by two or more ICD-9 codes. Multivariable logistic regression was performed to determine odds ratios (ORs) of SS adjusted for age, sex, and race.
Among 1861 patients with RA identified for cohort inclusion, 1296 had a reported smoking status. Current smokers were younger and less likely to be female than never smokers. The adjusted OR of current compared to never smokers was negatively associated with SS [OR 0.20, 95% confidence interval (CI) 0.06-0.65]. Female sex and age were associated with SS (OR 2.70, 95% CI 1.18-6.14; OR 3.75, 95% CI 1.23-11.4).
We report that RA patients who currently smoke had 80% lower odds of SS. Age had a 3.7-fold association and female sex a 2.7-fold association with SS among RA patients. Our data suggest a negative correlation between current smoking and prevalent SS among RA patients. Prospective studies examining pack-year relationships or smoking cessation could further examine risk reduction and causality to follow-up our cross-sectional observational study.
本病历回顾性研究旨在明确吸烟与干燥综合征（SS）之间的关联，研究对象为一个大型类风湿关节炎（RA）队列。
我们筛选了 2005 年至 2018 年间一个基于人群的队列中符合 RA 入选标准的电子健康记录。入选标准为年龄≥18 岁，至少有两次 RA 诊断，包括两次由风湿病医生做出的诊断，或存在类风湿因子或抗环瓜氨酸肽（抗-CCP）抗体阳性。吸烟状况为从未吸烟、当前吸烟或既往吸烟，作为独立变量。SS 通过两个或更多的 ICD-9 编码来定义。多变量逻辑回归用于确定调整年龄、性别和种族后 SS 的优势比（OR）。
在确定的 1861 例 RA 患者中，有 1296 例报告了吸烟状况。当前吸烟者比从不吸烟者更年轻，女性比例更低。与从不吸烟者相比，当前吸烟者患 SS 的调整 OR 呈负相关[OR 0.20，95%置信区间（CI）0.06-0.65]。女性和年龄与 SS 相关（OR 2.70，95% CI 1.18-6.14；OR 3.75，95% CI 1.23-11.4）。
我们报告称，目前吸烟的 RA 患者患 SS 的几率降低了 80%。在 RA 患者中，年龄与 SS 的相关性为 3.7 倍，女性与 SS 的相关性为 2.7 倍。我们的数据表明，RA 患者中当前吸烟与普遍 SS 之间存在负相关。进一步进行前瞻性研究，检查吸烟量与戒烟与 SS 的关系，可以进一步研究风险降低和因果关系，以随访我们的横断面观察性研究。
