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1.
Front Immunol ; 13: 881332, 2022.
Article in English | MEDLINE | ID: mdl-35720397

ABSTRACT

Objective: Higher 25-hydroxyvitamin D (25(OH)D) levels have been associated with reduced risk for autoimmune diseases and are influenced by vitamin D metabolism genes. We estimated genetically-determined vitamin D levels by calculating a genetic risk score (GRS) and investigated whether the vitamin D GRS was associated with the presence of autoantibodies related to rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in those at increased risk for developing RA and SLE, respectively. Methods: In this cross-sectional study, we selected autoantibody positive (aAb+) and autoantibody negative (aAb-) individuals from the Studies of the Etiologies of Rheumatoid Arthritis (SERA), a cohort study of first-degree relatives (FDRs) of individuals with RA (189 RA aAb+, 181 RA aAb-), and the Lupus Family Registry and Repository (LFRR), a cohort study of FDRs of individuals with SLE (157 SLE aAb+, 185 SLE aAb-). Five SNPs known to be associated with serum 25(OH)D levels were analyzed individually as well as in a GRS: rs4588 (GC), rs12785878 (NADSYN1), rs10741657 (CYP2R1), rs6538691 (AMDHD1), and rs8018720 (SEC23A). Results: Both cohorts had similar demographic characteristics, with significantly older and a higher proportion of males in the aAb+ FDRs. The vitamin D GRS was inversely associated with RA aAb+ (OR = 0.85, 95% CI = 0.74-0.99), suggesting a possible protective factor for RA aAb positivity in FDRs of RA probands. The vitamin D GRS was not associated with SLE aAb+ in the LFRR (OR = 1.09, 95% CI = 0.94-1.27). The SEC23A SNP was associated with RA aAb+ in SERA (OR = 0.65, 95% CI = 0.43-0.99); this SNP was not associated with SLE aAb+ in LFRR (OR = 1.41, 95% CI = 0.90 - 2.19). Conclusion: Genes associated with vitamin D levels may play a protective role in the development of RA aAbs in FDRs of RA probands, perhaps through affecting lifelong vitamin D status. The GRS and the SEC23A SNP may be of interest for future investigation in pre-clinical RA. In contrast, these results do not support a similar association in SLE FDRs, suggesting other mechanisms involved in the relationship between vitamin D and SLE aAbs not assessed in this study.


Subject(s)
Arthritis, Rheumatoid , Lupus Erythematosus, Systemic , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/genetics , Autoantibodies , Cohort Studies , Cross-Sectional Studies , Humans , Lupus Erythematosus, Systemic/epidemiology , Lupus Erythematosus, Systemic/genetics , Male , Risk Factors , Vitamin D , Vitamins
2.
J Pak Med Assoc ; 72(5): 891-895, 2022 May.
Article in English | MEDLINE | ID: mdl-35713051

ABSTRACT

OBJECTIVE: To determine the factors related to low bone density in postmenopausal women with rheumatoid arthritis. METHODS: The prospective cross-sectional study was conducted at the Rheumatology Department of Fauji Foundation Hospital, Rawalpindi, Pakistan, from June 1 to November 30, 2020, and comprised postmenopausal women with rheumatoid arthritis. On the basis of dual-energy X-ray absorptiometry scan of total hip, femoral neck, and lumbar spine, the subjects were categorised into osteoporosis, osteopenia and normal bone density groups. The risk factors were compared across these subgroups. Data was analysed using SPSS 21. RESULTS: Of the 114 women, 74(64.9%) had osteoporosis, 31(27.2%) had osteopenia and 9(7.9%) had normal bone mineral density. Those with osteoporosis were older (p<0.05), had low body mass index (p<0.002) and had a longer duration since menopause (p<0.004) compared to the other groups. Age and body mass index were significant factors associated with the condition (p<0.05). CONCLUSIONS: Older age, lesser body mass index and time since menopause were the factors significantly associated with osteoporosis.


Subject(s)
Arthritis, Rheumatoid , Bone Diseases, Metabolic , Osteoporosis , Absorptiometry, Photon , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Bone Density , Bone Diseases, Metabolic/diagnostic imaging , Bone Diseases, Metabolic/epidemiology , Cross-Sectional Studies , Female , Humans , Lumbar Vertebrae/diagnostic imaging , Osteoporosis/complications , Osteoporosis/diagnostic imaging , Osteoporosis/epidemiology , Postmenopause , Prospective Studies , Risk Factors
3.
Sci Rep ; 12(1): 10189, 2022 Jun 17.
Article in English | MEDLINE | ID: mdl-35715560

ABSTRACT

There is a clear relationship between rheumatoid arthritis (RA) and major osteoporotic fracture (MOF), although there is limited evidence on the effect of continuity of care (COC) on MOF in these patients. We investigated the association between COC and risk of MOF, including fractures of the lumbar spine and pelvis, forearm, and hip, among newly diagnosed RA patients aged ≥ 60 years. A total of 8715 incident RA patients from 2004 to 2010 were included from the Korean National Health Insurance Service-Senior cohort database. Participants were categorized into a good and bad COC group according to the COC index. The cumulative incidence of MOF was higher in RA patients with bad than in those with good COC (p < 0.001). The incidence rates of MOF were 4439 and 3275 cases per 100,000 person-years in patients with bad and good COC, respectively. RA patients with bad COC had an increased incidence of overall MOF (adjusted hazard ratio, 1.32; 95% confidence interval, 1.14-1.53), with the highest increase in risk being that of forearm fracture. An increased MOF risk in patients with bad COC was predominantly observed in females. This study suggested that interventions that can improve COC in patients with RA should be considered.


Subject(s)
Arthritis, Rheumatoid , Hip Fractures , Osteoporotic Fractures , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Cohort Studies , Continuity of Patient Care , Female , Hip Fractures/epidemiology , Humans , Incidence , Osteoporotic Fractures/complications , Osteoporotic Fractures/etiology , Risk Assessment , Risk Factors
4.
RMD Open ; 8(2)2022 Jun.
Article in English | MEDLINE | ID: mdl-35705306

ABSTRACT

OBJECTIVES: Previous research has demonstrated that patients with rheumatoid arthritis (RA) are less likely to breast feed their offspring. Treatment options for RA during lactation have expanded and the importance of counselling is recognised. The aim of the current research was to study breast feeding among women with RA who benefit from these developments. METHODS: Patients were derived from the Preconceptional Counselling in Active Rheumatoid Arthritis (PreCARA) cohort. Patients were treated according to a modified treat-to-target approach aimed at remission and received pregnancy counselling, including counselling on breast feeding. Postpartum visits were scheduled at 4-6, 12 and 26 weeks post partum. Prevalence of breast feeding at each postpartum visit was compared with a historical reference cohort (Pregnancy-induced Amelioration of Rheumatoid Arthritis cohort) and the general population. RESULTS: Data on 171 pregnancies were available for the current analysis. 120 (70.2%) patients with RA initiated breast feeding. 103/171 (60.2%), 68/171 (39.8%) and 45/171 (26.3%) patients with RA breast fed their offspring at 4-6, 12 and 26 weeks post partum, respectively. These percentages were higher at all postpartum visits compared with the historical reference cohort (p<0.001). In comparison with the general population, the rates were similar at each time point. CONCLUSION: Patients with RA in the PreCARA cohort were more likely to breast feed their offspring compared with patients with RA in the historical reference cohort. The breastfeeding rates observed were similar to breastfeeding rates among women in the general population. The increase in breast feeding among patients with RA may be due to the extension of lactation-compatible medication and pregnancy counselling.


Subject(s)
Arthritis, Rheumatoid , Breast Feeding , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , Counseling , Female , Humans , Lactation , Postpartum Period , Pregnancy
5.
RMD Open ; 8(2)2022 Jun.
Article in English | MEDLINE | ID: mdl-35701012

ABSTRACT

BACKGROUND: The crystal-induced calcium pyrophosphate deposition disease (CPPD) clinically appearing as pseudogout differs from the mere radiographic finding of chondrocalcinosis (CC) but may cause symptoms resembling rheumatoid arthritis (RA). OBJECTIVE: To study the prevalence of CPPD and CC in rheumatic diseases focusing on differences between seropositive and seronegative RA. PATIENTS AND METHODS: In a retrospective study design, we analysed records and radiographs of consecutive new patients presenting to our centre between January 2017 and May 2020. 503 patients were identified based on expert diagnoses: 181 with CPPD, 262 with RA, 142 seropositive (54.2%) and 120 seronegative RA, gout (n=30) and polymyalgia rheumatica (n=30), mean symptom duration <1 year in almost all patients. RESULTS: The majority of patients had only one rheumatological diagnosis (86.9%). Most patients with CPPD (92.6%) had radiographic CC, primarily in the wrists. The prevalence of CC was higher in seronegative (32.3%) than in seropositive RA (16.6%), respectively (p<0.001). Patients with CPPD were older (p<0.001) and had acute attacks more frequently than patients with RA (p<0.001), who had symmetric arthritis more often (p=0.007). The distribution pattern of osteoarthritic changes in radiographs of hands and wrists differs between patients with RA and CPPD. CC was present in more than one joint in 73.3% of patients with CPPD, 9.6% with seropositive and 18.7% with seronegative RA. DISCUSSION: CPPD and CC were more frequent in seronegative versus seropositive RA. Symmetry of arthritis and acuteness of attacks differentiated best between CPPD and RA but localisation of joint involvement did not. Co-occurrence of both diseases was frequently observed.


Subject(s)
Arthritis, Rheumatoid , Chondrocalcinosis , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Calcium Pyrophosphate , Chondrocalcinosis/diagnosis , Chondrocalcinosis/diagnostic imaging , Comorbidity , Humans , Prevalence , Retrospective Studies
6.
BMC Musculoskelet Disord ; 23(1): 549, 2022 Jun 07.
Article in English | MEDLINE | ID: mdl-35672724

ABSTRACT

BACKGROUND: Postural control is associated with fall risk. Patients with rheumatoid arthritis (RA) have a higher risk to fall than healthy subjects. The objective of this study was to identify associations between variables of postural control with prospective falls in patients with RA. METHODS: For the baseline, the balance performance of 289 men and women with RA, ages 24-85 years, was evaluated by SPPB, FICSIT-4 and Romberg tests. Postural sway for Romberg, semitandem, tandem and one-leg stands were measured with the Leonardo Mechanograph®. Self-reported disability was assessed using the Health Assessment Questionnaire (HAQ) and the Activity-specific Balance Confidence Scale (ABC-scale). Falls were reported in quarterly reports over a year. Univariate and multiple logistic regression analysis were used to explore any associations with falling. Receiver-operating characteristics were determined, and the area under the curve is reported. RESULTS: A total of 238 subjects completed the 1-year follow-up, 48 (20.2%) experienced at least one fall during the observational period. Age (OR = 1.04, CI 1.01-1.07), HAQ (OR = 1.62, 1.1-2.38), FICSIT-4 scoring 0-4 (OR = 2.38, 1.13-5.0), and one-leg standing (OR = 2.14, 1.06-4.31) showed significant associations with falls. With regard to the SPPB and ABC-scale, no statistically significant associations with falls were found. The quartiles containing the worst results of medio-lateral sway of Romberg (OR = 2.63, CI 1.03-6.69), total sway of semitandem (OR = 3.07, CI 1.10-8.57) and tandem (OR = 2.86, CI 1.06-7.69), and area of sway of semitandem (OR = 2.80, CI 1.11-7.08) stands were associated with falls. CONCLUSIONS: The assessment of a one-leg stand seems to be a good screening tool to discriminate between high and low risk of falls in RA patients in clinical practice. A low FICSIT-4 score and several sway parameters are important predictors of falls. TRIAL REGISTRATION: The study has been registered at the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform (ICTRP) since 16 March 2017 ( DRKS00011873 ).


Subject(s)
Accidental Falls , Arthritis, Rheumatoid , Adult , Aged , Aged, 80 and over , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/epidemiology , Female , Humans , Male , Middle Aged , Postural Balance , Prospective Studies , Young Adult
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 56(5): 574-582, 2022 May 06.
Article in Chinese | MEDLINE | ID: mdl-35644970

ABSTRACT

Objective: To investigate the characteristics of non-alcoholic fatty liver disease (NAFLD) and its associated factors in rheumatoid arthritis (RA) patients. Methods: This cross-sectional study recruited 385 RA patients [including 72 (18.7%) male and 313 (81.3%) female] who received abdominal sonographic examination from August 2015 to May 2021 at Department of Rheumatology, Sun Yat-Sen Memorial Hospital. There were 28 RA patients at 16-29 years old and 32, 80, 121, 99, 25 at 30-39, 40-49, 50-59, 60-69, ≥ 70 years old, respectively. Demographic and clinical data were collected including age, gender, history of alcohol consumption, disease duration, body mass index (BMI), waist circumference, blood pressure, RA disease activity indicators and previous medications. Logistic regression analyses were used to identify the associated factors of NAFLD in RA patients. Results: The prevalence of NAFLD was 24.2% (93/385) in RA patients, 26.3% (21/80) in 40-49 age group and 33.1% (40/121) in 50-59 age group. There were 22.1% (85/385) and 3.6% (14/385) RA patients with overweight and obese, in which the prevalence of NAFLD was 45.9% (39/85) and 78.6% (11/14) respectively, which was 2.6 folds and 4.5 folds that of RA patients with normal BMI. Although there was no significant difference of age, gender and RA disease activity indicators between RA patients with or without NAFLD, those with NAFLD had higher proportions of metabolic diseases including obese (11.8% vs. 1.0%), central obesity (47.3% vs. 16.8%), hypertension (45.2% vs. 29.8%) and type 2 diabetes mellitus (24.7% vs. 12.0%), consistent with higher levels of total cholesterol [(5.33±1.31) mmol/L vs. (4.73±1.12) mmol/L], triglyceride [(1.51±1.08) mmol/L vs. (0.98±0.54) mmol/L] and low-density lipoprotein cholesterol [(3.37±0.97) mmol/L vs. (2.97±0.78) mmol/L, all P<0.05]. Multivariate logistic regression analysis showed that BMI (OR=1.314) and triglyceride (OR=1.809) were the independent factors positively associated with NAFLD in RA patients. Conclusion: NAFLD is a common comorbidity in RA patients, especially in those with middle-aged, overweight or obese, which is associated with high BMI or high triglyceride. Screening and management of NAFLD in RA patients especially those with overweight, obese or dyslipidemia should be emphasized.


Subject(s)
Arthritis, Rheumatoid , Non-alcoholic Fatty Liver Disease , Adolescent , Adult , Aged , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Cholesterol, LDL , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/epidemiology , Obesity/complications , Obesity/epidemiology , Overweight/complications , Overweight/epidemiology , Triglycerides , Young Adult
9.
J Affect Disord ; 311: 407-415, 2022 08 15.
Article in English | MEDLINE | ID: mdl-35642835

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) and depression are conditions which commonly co-exist. Recent longitudinal studies now suggest a bidirectional association between these disorders, with inconsistent results. We conducted a systematic review and meta-analysis to examine this relationship. METHODS: Three electronic databases (PubMed, Embase and PsycINFO) were searched from inception to September 4, 2021 for cohort studies evaluating either the risk of depression in RA patients or the risk of RA in patients with depression, as well as the secondary outcome of all-cause mortality risk in RA patients with depression. A random effects model was used to summarize the included studies. RESULTS: Eleven cohort studies were included, comprising a total of 39,130 RA patients, 550,782 patients with depression and 7,802,230 controls. RA patients had a 47% greater risk of incident depression compared to controls, while patients with depression had a 34% greater risk of developing RA. Subgroup analysis by age was only significant in the ≥60 years old age group. RA patients with depression had an 80% increased risk of all-cause mortality compared to those without depression. LIMITATIONS: The results may have been confounded by factors such as differing methods of depression ascertainment across studies and overlap in presentation between the two conditions. CONCLUSION: There exists a bidirectional association between RA and depression especially in the elderly which increases mortality risk. This invites the need for clinicians to screen and be vigilant for the presence of these conditions.


Subject(s)
Arthritis, Rheumatoid , Depression , Aged , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Cohort Studies , Depression/epidemiology , Humans , Middle Aged , Risk Factors
10.
Pharmacol Res ; 181: 106278, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35644324

ABSTRACT

OBJECTIVES: To investigate the effect of biologic therapy on risk of fracture in selected rheumatic and autoimmune diseases. METHODS: The PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to June 4, 2021. Randomized clinical trials (RCTs) comparing biological disease-modifying antirheumatic drugs (bDMARDs) with non-bDMARDs or placebo in patients with five selected rheumatic and autoimmune diseases were included. Meta-analyses were conducted to calculate the odds ratio (OR) with 95 % confidence intervals (CIs) for major osteoporotic fracture, hip fracture, osteoporotic non-vertebral fracture, and total fracture. RESULTS: A total of 100 RCTs involving 51,413 participants fulfilled the inclusion criteria. In patients with psoriasis (Ps), and psoriatic arthritis (PsA), compared with placebo or non-bDMARDs therapy, the risk of major osteoporotic fracture (OR, 0.34 [95 %Cl, 0.15-0.76], p = 0.009), hip fracture (OR, 0.22 [95 %Cl, 0.05-0.89], p = 0.03), and osteoporotic non-vertebral fracture (OR, 0.26 [95 %Cl, 0.10-0.62], p = 0.003) were significantly decreased with the use of bDMARDs. In patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), systemic lupus erythematosus (SLE), and inflammatory bowel diseases (IBD), the risk of fracture were not changed with biologic treatment. CONCLUSIONS: The existing evidence from RCTs indicated the use of bDMARDs was associated with a low risk of major osteoporotic fracture, hip fracture, and osteoporotic non-vertebral fracture in patients with Ps and PsA. There are still urgent needs for studies regarding the actions of biologic therapies on the risk of bone fractures in systemic inflammatory diseases.


Subject(s)
Antirheumatic Agents , Arthritis, Psoriatic , Arthritis, Rheumatoid , Hip Fractures , Osteoporotic Fractures , Psoriasis , Antirheumatic Agents/therapeutic use , Arthritis, Psoriatic/complications , Arthritis, Psoriatic/drug therapy , Arthritis, Psoriatic/epidemiology , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , Biological Therapy , Hip Fractures/drug therapy , Humans , Incidence , Osteoporotic Fractures/drug therapy , Psoriasis/complications , Psoriasis/drug therapy , Psoriasis/epidemiology , Randomized Controlled Trials as Topic
11.
Immun Inflamm Dis ; 10(6): e633, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35634962

ABSTRACT

OBJECTIVE: We conducted a retrospective case-control study to investigate the risk factors for osteonecrosis of the femoral head (ONFH) in rheumatoid arthritis (RA) patients. METHODS: The clinical data of patients diagnosed with RA at Fujian Provincial Hospital from January 2013 to December 2020 were retrospectively collected and evaluated. Twenty-two patients with ONFH were identified. Eighty-eight age-, sex-, and disease duration-matched RA patients without symptomatic ONFH were randomly selected as controls in a ratio of 1:4. Logistic regression analysis was used to analyze the risk factors. RESULTS: The anticardiolipin (ACL)-immunoglobulin G (IgG) concentration, clinical disease activity index, simplified disease activity index, incidence of hyperlipidemia in the case group were higher than those in the control group. Multivariate logistic regression analysis did not find the independent risk factor in ONFH patients with RA. CONCLUSION: The pathogenesis of ONFH in RA is related to many factors such as ACL IgG, disease activity index, and hyperlipidemia. While, we went to great lengths to explore the relationship between antiphospholipid antibodies and ONFH, but it plays a very small role.


Subject(s)
Arthritis, Rheumatoid , Femur Head Necrosis , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Case-Control Studies , Female , Femur Head/pathology , Femur Head Necrosis/epidemiology , Femur Head Necrosis/etiology , Femur Head Necrosis/pathology , Humans , Immunoglobulin G , Male , Retrospective Studies
12.
Int J Environ Res Public Health ; 19(10)2022 05 10.
Article in English | MEDLINE | ID: mdl-35627350

ABSTRACT

(1) Background: Smoking cessation may be very difficult, even if smoking aggravates the prognosis of a disease, which has been shown to be the case for persons with rheumatoid arthritis (RA). In contrast, an association in patients with osteoarthritis (OA) is still disputed. The primary objective was to compare smokers diagnosed with RA and OA to controls, regarding smoking cessation rates after following the intensive 'Gold Standard programme' (GSP). Secondary objectives included the identification of significant prognostic factors for successful quitting. (2) Methods: In total, 24,652 patients were included in this prospective cohort study, after attending the national GSP for smoking cessation intervention 2006-2016, as registered in the Danish Smoking Cessation Database. Data were linked to the National Patient Register. Hereof, 227 patients (1%) were diagnosed with seropositive RA and 2899 (12%) with OA. Primary outcome was continuous abstinence six months after the planned quitting date. (3) Results: In total, 16,969 (69%) of the patients participated in the follow-up interviews. The adjusted odds ratios for successful quitting were similar to the control group for both RA (1.28, 95% CI: 0.90-1.80) and OA patients (0.92, 0.82-1.03). The outermost, strongest positive factor for successful quitting was compliance, defined as attending ≥75% of the meetings. To a lesser degree, attending an individual intervention was a positive predictor, while being heavy smokers, disadvantaged smokers, women, living with a smoker, and if GSP was recommended by health professionals were negative predictors. (4) Conclusions: The odds ratios for quitting were similar to controls for both RA and OR patients. Additional research is needed to determine effective actions towards increased attendance at the programmes.


Subject(s)
Arthritis, Rheumatoid , Osteoarthritis , Smoking Cessation , Arthritis, Rheumatoid/diagnosis , Arthritis, Rheumatoid/epidemiology , Denmark/epidemiology , Female , Humans , Osteoarthritis/epidemiology , Prospective Studies
13.
Medicine (Baltimore) ; 101(19): e29309, 2022 May 13.
Article in English | MEDLINE | ID: mdl-35583542

ABSTRACT

ABSTRACT: Little is known within the medical community about the impact of air pollution on hospital admissions due to rheumatoid arthritis associated with interstitial lung disease (RA-ILD). Our research aimed to explore whether there is a correlation and to estimate how the association was distributed across various lags in Jinan, China.The relationships between ambient air pollutant concentrations, including PM2.5, PM10, sulfur dioxide (SO2), ozone (O3), and nitrogen dioxide (NO2), and monthly hospitalizations for RA-ILD were studied by employing a general linear model with a Poisson distribution. This time-series study was performed from January 1st, 2015 to December 31st, 2019.In the 5-year study, there were 221 hospitalizations for RA-ILD in Jinan city. The levels of PM2.5, PM10, SO2, and NO2 were significantly related to the number of admissions for RA-ILD. PM2.5, PM10, and SO2 showed the most significant effect on the month (lag 0), and NO2 was most related to RA-ILD at a lag of two months (lag 2). The monthly admissions of RA-ILD increased by 0.875% (95% CI: 0.375-1.377%), 0.548% (95% CI: 0.148-0.949%), 1.968% (95% CI: 0.869-3.080%), and 1.534% (95% CI: 0.305-2.778%) for each 10 µg/m3 increase in PM2.5, PM10, SO2 and NO2, respectively.This study might add more detailed evidence that higher levels of PM2.5, PM10, SO2 and NO2 increase the risk of hospitalizations for RA-ILD. Further study of the role of air pollution in the pathogenesis of RA-ILD is warranted.


Subject(s)
Air Pollutants , Air Pollution , Arthritis, Rheumatoid , Lung Diseases, Interstitial , Ozone , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Arthritis, Rheumatoid/epidemiology , China/epidemiology , Hospitalization , Humans , Nitrogen Dioxide , Ozone/adverse effects , Particulate Matter/adverse effects , Particulate Matter/analysis , Sulfur Dioxide/analysis
14.
Women Health ; 62(4): 302-314, 2022 04.
Article in English | MEDLINE | ID: mdl-35575123

ABSTRACT

To evaluate the current state of the evidence regarding the association of silicone breast implantation with the onset of connective tissue diseases, constitutional symptoms, and rheumatic serological profile in adult women. A comprehensive search was carried out using MEDLINE, Embase, Web of Science and Scopus, from inception to September 2, 2020. Cohort studies assessing the clinical and serological profile of women with cosmetic breast implants were included. Meta-analyses were conducted using risk ratios. A total of 10 cohorts with overall moderate quality of evidence were included in this systematic review. Exposure to silicone breast implants was slightly associated with the development of rheumatoid arthritis [RR: 1.35; (95% CI 1.08 to 1.68); P = .008; I2 = 0%]. However, no significant differences were exhibited between the breast implant-exposed population and controls regarding the rest of the outcomes. In adult women, exposure to silicone breast implantation is not associated with the onset of constitutional symptoms and most connective tissue diseases. A marginal association with rheumatoid arthritis was exhibited, but the certainty of this result is jeopardized by the significant amount of self-reported data for this outcome. Further research is required to adequately explore the clinical significance of these results.


Subject(s)
Arthritis, Rheumatoid , Breast Implants , Connective Tissue Diseases , Adult , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/etiology , Breast Implants/adverse effects , Connective Tissue Diseases/diagnosis , Connective Tissue Diseases/epidemiology , Connective Tissue Diseases/etiology , Consensus , Female , Humans , Silicones/adverse effects
15.
Front Endocrinol (Lausanne) ; 13: 862849, 2022.
Article in English | MEDLINE | ID: mdl-35527996

ABSTRACT

Background: The prevalence of rheumatoid arthritis (RA) has significant gender and age difference. The peak age of RA is consistent with the age of menopause, which is accompanied by a sharp increase in serum follicle-stimulating hormone (FSH) level. This study aims to identify the FSH levels in female RA patients and the relationship with diseases activity. Methods: In total, 79 female RA patients and 50 age-matched controls were included in our study. Serum sex hormones levels were measured using chemiluminescence. RA patients were grouped by FSH quartile. Disease activity and inflammatory marks were analyzed among groups. Results: Lower sex hormones and higher gonadotropin were found in RA patients. Serum FSH level was significantly higher in RA patients than in the age-match controls (57.58 ± 15.94 vs. 43.11 ± 19.46, p=0.025). Even after adjusting for age (OR: 1.071; 95%CI: 1.006-1.139; p = 0.031), luteinizing hormone (LH), estradiol (E), and testosterone (T) OR: 1.066; 95%CI: 1.003-1.133; p = 0.039), the OR were still more than one. RA patients in the higher quartiles had higher ESR, DAS28-ESR and DAS28-CRP (p<0.05) than the lowest quartile. Besides, menopause age was significantly related with onset age in post-menopause RA patients (r = 0.432, p =0.008). Conclusion: High FSH appears to be a risk factor for RA and is positively associated with their disease activity. Early menopause might be an essential factor of RA.


Subject(s)
Arthritis, Rheumatoid , Follicle Stimulating Hormone , Arthritis, Rheumatoid/epidemiology , Estradiol/blood , Female , Follicle Stimulating Hormone/blood , Gonadal Steroid Hormones/blood , Humans , Luteinizing Hormone/blood , Testosterone/blood
16.
Br J Community Nurs ; 27(5): 232-241, 2022 May 02.
Article in English | MEDLINE | ID: mdl-35522453

ABSTRACT

This systematic review and meta-analysis estimates the prevalence of common comorbid health disorders in adults with rheumatoid arthritis (RA). A multi-database search strategy was undertaken. Screening, data extraction and quality assessment were carried out by two independent reviewers. A meta-analysis and meta-regression were used to generate a pooled prevalence estimate and identify relevant moderators. After study selection, 33 studies (74633 participants) were included in the meta-analysis. Some 31 studies were judged to be of low risk of bias, and two studies were judged to be at moderate risk of bias. The three most common comorbidities in RA were anxiety disorders (62.1%, 95% Cl: 43.6%; 80.6%), hypertension (37.7%, 95% Cl: 29.2%; 46.2%) and depression (32.1%, 95% Cl: 21.6%; 42.7%). There was substantial statistically significant heterogeneity for all comorbidities (I2 ≥77%). Meta-regression identified that the covariate of mean age (unit increase) had a statistically significant effect on the prevalence of hypertension (+2.3%, 95% Cl: 0.4%; 4.2%), depression (-0.5%, 95% Cl: -0.6%; -0.4%) and cancer (0.5%, 95% Cl: 0.2%; 0.8%) in adults with RA. A country's income was identified to have a statistically significant effect on the prevalence of depression, with low-to moderate-income countries having 40% (95% Cl: 14.0%; 66.6%) higher prevalence than high-income countries. No studies consider health inequalities. It is concluded that comorbidities are prevalent among people with RA, particularly those associated with mental health and circulatory conditions. Provision of health services should reflect the importance of such multimorbidity and the consequences for quality and length of life.


Subject(s)
Arthritis, Rheumatoid , Hypertension , Adult , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/epidemiology , Comorbidity , Humans , Mental Health , Prevalence
17.
Adv Rheumatol ; 62(1): 13, 2022 05 03.
Article in English | MEDLINE | ID: mdl-35505408

ABSTRACT

BACKGROUND: Patients using immunosuppressive drugs may have unfavorable results after infections. However, there is a lack of information regarding COVID-19 in these patients, especially in patients with rheumatoid arthritis (RA). Therefore, the aim of this study was to evaluate the risk factors associated with COVID-19 hospitalizations in patients with RA. METHODS: This multicenter, prospective cohort study is within the ReumaCoV Brazil registry and included 489 patients with RA. In this context, 269 patients who tested positive for COVID-19 were compared to 220 patients who tested negative for COVID-19 (control group). All patient data were collected from the Research Electronic Data Capture database. RESULTS: The participants were predominantly female (90.6%) with a mean age of 53 ± 12 years. Of the patients with COVID-19, 54 (20.1%) required hospitalization. After multiple adjustments, the final regression model showed that heart disease (OR = 4.61, 95% CI 1.06-20.02. P < 0.001) and current use of glucocorticoids (OR = 20.66, 95% CI 3.09-138. P < 0.002) were the risk factors associated with hospitalization. In addition, anosmia was associated with a lower chance of hospitalization (OR = 0.26; 95% CI 0.10-0.67, P < 0.005). CONCLUSION: Our results demonstrated that heart disease and the use of glucocorticoids were associated with a higher number of hospital admissions for COVID-19 in patients with RA. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials - RBR-33YTQC.


Subject(s)
Arthritis, Rheumatoid , COVID-19 , Heart Diseases , Adult , Aged , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , Brazil/epidemiology , Female , Glucocorticoids , Hospitalization , Humans , Male , Middle Aged , Prospective Studies , Registries
18.
Biomed Pharmacother ; 150: 112997, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35486976

ABSTRACT

BACKGROUND: This study aimed to investigate the seroreactivity of Coronavirus disease 2019 (COVID-19) vaccination and its adverse events among systemic lupus erythematosus (SLE) patients, rheumatoid arthritis (RA) patients, and healthy controls (HCs). METHODS: A total of 60 SLE patients, 70 RA patients and 35 HCs, who received a complete inactivated COVID-19 vaccine (Vero cells) regimen, were recruited in the current study. Serum IgG and IgM antibodies against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) were determined by using chemiluminescent microparticle immunoassay (CMIA). RESULTS: There were no significant differences regarding the seroprevalences of IgG and IgM antibodies against SARS-CoV-2, and the self-reported vaccination-related adverse events among SLE patients, RA patients and HCs. The inactivated COVID-19 vaccines appeared to be well-tolerated and moderately immunogenic. In addition, case-only analysis indicated that in SLE patients, the disease manifestation of rash and anti-SSA autoantibody were associated with seroprevalence of IgG antibody against SARS-CoV-2, whereas the uses of ciclosporin and leflunomide had influence on the seroprevalence of IgM antibody against SARS-CoV-2. In RA patients, rheumatoid factor (RF) appeared to be associated with the seroprevalence of IgG antibody against SARS-CoV-2. CONCLUSION: Our study reveals that the seroprevalences of IgG and IgM antibodies against SARS-CoV-2 and vaccination-related adverse effects are similar among SLE, RA and HCs, suggesting that COVID-19 vaccine is safe and effective for SLE and RA patients to prevent from the pandemic of COVID-19.


Subject(s)
Arthritis, Rheumatoid , COVID-19 , Lupus Erythematosus, Systemic , Animals , Antibodies, Viral , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Chlorocebus aethiops , Humans , Immunoglobulin G , Immunoglobulin M , SARS-CoV-2 , Seroepidemiologic Studies , Vaccination , Vero Cells
19.
Nutrients ; 14(8)2022 Apr 08.
Article in English | MEDLINE | ID: mdl-35458116

ABSTRACT

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects the joints. The multifactorial etiopathogenesis of RA has been heavily investigated, but is still only partially understood. Diet can represent both a risk factor and a protective factor, based on some evidence that suggests specific properties of certain foods and their ability to increase/reduce inflammation. To date, the studies done on this topic provide discordant results and are heterogeneous in terms of design and cohort size. In this work, we investigated for the first time the relationship between nutrition and the risk of RA onset using a sample size of about half a million subjects from one of the largest publicly available biobanks that is the UK biobank. Results showed that oily fish, alcohol, coffee and breakfast cereals have protective roles in RA; whereas, tea can increase the risk of RA. In conclusion, the obtained results confirm that diet plays key roles in RA, either by promoting or by preventing RA onset and development. Future research should focus on unravelling the effects of dietary habits on immune-mediated diseases to establish better preventive strategies.


Subject(s)
Arthritis, Rheumatoid , Biological Specimen Banks , Animals , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/etiology , Arthritis, Rheumatoid/prevention & control , Coffee , Humans , Nutritional Status , United Kingdom/epidemiology
20.
RMD Open ; 8(1)2022 04.
Article in English | MEDLINE | ID: mdl-35450954

ABSTRACT

Physical and mental illnesses are driven by ethnicity, social, environmental and economic determinants. Novel theoretical frameworks in rheumatoid arthritis (RA) focus on links and adverse interactions between and within biological and social factors. This review aimed to summarise associations between socioeconomic status (SES) and RA disease activity, and implications for future research. Articles studying the association between SES and RA disease activity were identified, from 1946 until March 2021. The research question was: Is there an association between social deprivation and disease activity in people with RA? Articles meeting inclusion criteria were examined by one author, with 10% screened at abstract and full paper stage by a second author. Disagreements were resolved with input from a third reviewer. Information was extracted on definition/measure of SES, ethnicity, education, employment, comorbidities, disease activity and presence/absence of association between SES and disease activity. Initially, 1750 articles were identified, with 30 articles ultimately included. SES definition varied markedly-10 articles used a formal scale and most used educational attainment as a proxy. Most studies controlled for lifestyle factors including smoking and body mass index, and comorbidities. Twenty-five articles concluded an association between SES and RA disease activity; two were unclear; three found no association. We have demonstrated the association between low SES and worse RA outcomes. There is a need for further research into the mechanisms underpinning this, including application of mixed-methods methodology and consideration of syndemic frameworks to understand bio-bio and bio-social interactions, to examine disease drivers and outcomes holistically.


Subject(s)
Arthritis, Rheumatoid , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/etiology , Humans , Life Style , Social Class
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