Menopausal factors and risk of seropositive rheumatoid arthritis in postmenopausal women: a nationwide cohort study of 1.36 million women

Abstract

In previous literature regarding development of rheumatoid arthritis (RA), female reproductive factors have been described as protective factors, risk factors, or irrelevant, leading to inconsistent results. The aim of this study was to investigate the effect of female reproductive factors on the incidence of seropositive RA. A large population-based retrospective cohort of the National Health Insurance Service data in South Korea was used. Postmenopausal women who participated in both cardiovascular and breast cancer screening in 2009 were included and followed until date of seropositive RA diagnosis, death, or December 31, 2018. Multivariable-adjusted Cox proportional hazards model was used to assess the association between reproductive factors and incident seropositive RA. Of 1,357,736 postmenopausal women, 6056 women were diagnosed with seropositive RA, and the incidence rate was 54.16 cases/100,000 person-years. Reproductive factors other than hormone replacement therapy (HRT) were not significantly associated with seropositive RA incidence. Postmenopausal women who used HRT ≥ 5 years were associated with a higher aHR of incident seropositive RA than never-users (aHR 1.25; 95% CI 1.09–1.44). Alcohol consumption less than 30 g per day (aHR 0.80; 95% CI 0.74–0.87), regular physical activity (aHR 0.90; 95% CI 0.84–0.97), diabetes mellitus (aHR 0.85; 95% CI 0.78–0.93), and cancer (aHR 0.77; 95% CI 0.64–0.92) were associated with lower risk of seropositive RA. Most female reproductive factors did not significantly affect the development of seropositive RA in postmenopausal women. Only HRT is associated with a small but significant increase in risk of seropositive RA.

Impact of early age at menopause on disease outcomes in postmenopausal women with rheumatoid arthritis: a large observational cohort study of Korean patients with rheumatoid arthritis

“…Several earlier studies have demonstrated EM as a risk factor for the development of RA 8 14. Conversely, recent large-scale cohort studies have shown either no association or a significant association between age at menopause and RA risk only among smokers 17 18…”

“… 8 14 Conversely, recent large-scale cohort studies have shown either no association or a significant association between age at menopause and RA risk only among smokers. 17 18 …”

Population-based study for the comorbidities and associated factors in Ménière’s disease

“… Diagnostic code Prescription ICD-10 Registration V code ATC code or ingredients Days or no. of prescription Autoimmune diseases Rheumatic Systemic lupus erythematosus 41 M32 V136 Dermatomyositis/ polymyositis 42 M33 V137 Systemic sclerosis 43 M34 V138 Sjogren’s syndrome 44 M350 V139 Ankylosing spondylitis 45 M45 V140 Rheumatoid arthritis 46 M05 V223 Non-rheumatic Type 1 DM E10 A10 (drugs used in diabetes) ≥ 1 year Grave’s disease 47 E050, E058, E059 Methimazole, propylthiouracil, or carbimazole ≥ 60 days Hashimoto’s thyroiditis 47 E063, E069 Levothyroxine sodium or liothyronine sodium ≥ 60 days Crohn’s disease 48 …”

Altered Risk of Incident Gout According to Changes in Metabolic Syndrome Status: A Nationwide, Population‐Based Cohort Study of 1.29 Million Young Men

“…From 2008 to 2019, the participation rate in health check-ups was 67.3-75.6% in the total population, 63.7-89.5% in people ages 20-29 years, and 72.2-85.2% in people ages 30-39 years (25). Health check-up information is collected by the NHIS and is used in various epidemiologic studies, such as studies identifying risk factors for disease, in connection with other information in the claims database (16,26,27).…”