Voigt L F, Koepsell T D, Nelson J L, Dugowson C E, Daling J R
Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Epidemiology. 1994 Sep;5(5):525-32.
There is some evidence that sex hormones may influence the incidence of rheumatoid arthritis. Obesity has been found to increase endogenous estrogens, particularly among postmenopausal women. Although the association of endogenous hormones with smoking and alcohol use is less clear, we examined the relation of these three factors with rheumatoid arthritis in women. We conducted a population-based case-control study of rheumatoid arthritis in King County, WA, and Group Health Cooperative of Puget Sound. We compared 349 incident cases of rheumatoid arthritis with 1,457 controls selected by random digit dialing or by random selection from the enrollment files of Group Health Cooperative. We conducted personal interviews to collect data on weight, smoking, alcohol history, reproductive variables, and other demographic variables. Women with 20 or more pack-years of smoking had a relative risk of 1.5 [95% confidence interval (CI) = 1.0-2.0] compared with never-smokers. Post-menopausal women who averaged more than 14 alcoholic drinks per week had a reduced risk of rheumatoid arthritis (relative risk = 0.5; 95% CI = 0.2-1.7). Women in the highest quartile of body mass index had a risk of 1.4 (95% CI = 1.0-2.0) relative to women with lowest body mass index.
有证据表明性激素可能会影响类风湿性关节炎的发病率。研究发现肥胖会增加内源性雌激素水平，尤其是在绝经后女性中。尽管内源性激素与吸烟和饮酒之间的关联尚不清楚，但我们研究了这三个因素与女性类风湿性关节炎之间的关系。我们在华盛顿州金县和普吉特海湾健康合作组织开展了一项基于人群的类风湿性关节炎病例对照研究。我们将349例类风湿性关节炎新发病例与通过随机数字拨号或从健康合作组织登记档案中随机选取的1457名对照进行了比较。我们通过个人访谈收集了体重、吸烟、饮酒史、生殖变量及其他人口统计学变量的数据。与从不吸烟的女性相比，吸烟量达到或超过20包年的女性相对风险为1.5 [95%置信区间(CI)=1.0 - 2.0]。每周平均饮酒超过14杯的绝经后女性患类风湿性关节炎的风险降低(相对风险 = 0.5；95% CI = 0.2 - 1.7)。与体重指数最低的女性相比，体重指数处于最高四分位数的女性风险为1.4(95% CI = 1.0 - 2.0)。
