The Annual European Congress of Rheumatology
AB0179
A recent case-control study has suggested an inverse association between alcohol intake and the risk of developing rheumatoid arthritis (RA). Moreover, in experimental studies with collagen-induced arthritis in mice, alcohol had an anti-inflammatory and anti-destructive effect. It is unclear however, if the protective effect of alcohol is specific for RA, or whether it is also present in other kinds of arthritis.
To evaluate whether there is an inverse correlation between alcohol consumption and the risk of developing rheumatoid arthritis.
Included were patients from the Leiden Early Arthritis Cohort (EAC) with RA (n=651), other forms of arthritis (reactive arthritis, spondylarthropathy or psoriatic arthritis) (n=273) and osteoarthritis (OA) (n=73), as well as 5877 general population controls from the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis study. Alcohol consumption was recorded at baseline. The effect of alcohol consumption on the risk of developing disease was analyzed by univariate and multivariate logistic regression. The latter analysis was corrected for age and gender since these differed between the various groups.
Alcohol consumption was associated with a significantly lower risk of RA. However, alcohol intake was also associated with a significantly lower risk of other forms of arthritis and OA(Table 1). The degree of systemic inflammation, as reflected by the level of the erythrocyte sedimentation rate (ESR), was inversely correlated with alcohol consumption.
To investigate if alcohol consumption may be particularly protective against the development of RA compared to other arthritides, a subgroup analysis was performed comparing the RA patients stratified for ACPA-status, with the patients with other forms of arthritis (n=273).
This revealed a particularly protective effect in ACPA-positive RA patients (n=257) (OR 0.59, 95% CI 0.36-0.99), which did not remain significant however, after adjustment for the ESR-level (OR 0.63, 95% CI 0.38-1.07).
Patients presenting with arthritis report less alcohol consumption than population controls, regardless of the type of arthritis. The inverse correlation between the ESR level and alcohol consumption suggests that patients with more severe systemic inflammation drink less alcohol, or alternatively, that alcohol may protect against the development of more systemic inflammation.
Although we cannot exclude that alcohol consumption may be particularly protective against ACPA-positive RA, it appears that the largest part of the protective effect of alcohol is not specific for rheumatoid arthritis.
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