Hormonal and reproductive factors in relation to the risk of rheumatoid arthritis in women: a prospective cohort study with 223 526 participants

Abstract

ObjectiveThis study aimed to examine rheumatoid arthritis (RA) risk associated with hormonal and reproductive factors in women from the large cohort of the UK Biobank.MethodsData on hormonal and reproductive factors in women were collected from a prospective cohort of 223 526 UK Biobank participants. The potential relationship between reproductive factors and RA risk was assessed using restricted cubic spline. Hazard ratios (HR) were estimated using Cox proportional hazard regressions.ResultsDuring a median follow-up of 12.39 years, 3313 women with RA were identified. Age at menarche >14 years was associated with a greater RA risk (HR 1.13, 95% CI 1.02 to 1.26) compared with menarche at 13. The multiple adjusted HR for RA in women with menopause at <45 years was 1.46. Reproductive years <33 increased the risk of RA (HR 1.39, 95% CI 1.21 to 1.59). Compared with those with 2 children, women with ≥4 children were associated with a higher risk of RA (HR 1.18, 95% CI 1.04 to 1.34). Women who had a hysterectomy (HR 1.40, 95% CI 1.25 to 1.56) or oophorectomy (HR 1.21, 95% CI 1.08 to 1.35) had a higher risk of RA than those without a hysterectomy or oophorectomy. Both hormone replacement therapy (HRT) use (HR 1.46, 95% CI 1.35 to 1.57) and HRT duration (HR 1.02, 95% CI 1.01 to 1.03) were associated with a higher risk of RA.ConclusionsSome hormonal and reproductive factors were associated with a higher risk of RA. Hormonal and reproductive factors should be considered in risk assessment and formulating management plans in female patients with RA.

Prevalence of anemia in patients with rheumatoid arthritis and its association with dietary inflammatory index: A population-based study from NHANES 1999 to 2018

“…It was interesting to note that an adjusted association of DII levels with anemia was statistically significant in females but not males in our subgroup analyses, which may be related to hormones and gender-related factors [ 47 ] (Table 4 ). Moreover, Mexicans with high DII levels had a substantially increased risk of anemia, but there was no such association among other races.…”

No causal association between pneumoconiosis and three inflammatory immune diseases: a Mendelian randomization study

“…Nevertheless, Studies have constraints in their ability to detect and investigate isolated exposures and are unable to confirm the pathophysiology or causation of pneumoconiosis and inflammatory immune disorders, despite indications of a link between the two diseases. Two-sample Mendelian randomization (MR) method, as an effective method using genetic variation as instrumental variables (IVs), has been used to explore the causal associations between inflammatory immune diseases and other diseases, such as healthy lifestyle, atopic dermatitis, and hormonal factors (14)(15)(16). Genetic variation could minimize confounding, give stronger causal reasoning, and overcome some of the limitations of classic observational research since it is unaffected by other variables or the external environment.…”