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High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study.

Abstract

INTRODUCTION

Environmental exposures, including smoking, hormone-related factors, and metabolic factors, have been implicated in the etiology of rheumatoid arthritis (RA). A previous study has indicated that blood lipid levels may influence the development of RA. The objective of this study was to investigate the impact of serum total cholesterol and triglycerides on the risk of RA in a prospective study.

METHODS

Among participants in a large population-based health survey (n = 33,346), individuals who subsequently developed RA were identified by linkage to four different registers and a structured review of the medical records. In a nested case-control study, with controls, matched for age, sex, and year of inclusion, from the health survey database, the relation between serum lipids (levels of total cholesterol and triglycerides) and future RA development was examined.

RESULTS

In total, 290 individuals (151 men and 139 women) whose RA was diagnosed a median of 12 years (range of 1-28) after inclusion in the health survey were compared with 1160 controls. Women with a diagnosis of RA during the follow-up had higher total cholesterol levels at baseline compared with controls: odds ratio (OR) 1.54 per standard deviation; 95 % confidence interval (CI) 1.22-1.94. This association remained statistically significant in multivariate models adjusted for smoking and a history of early menopause and in analyses stratified by rheumatoid factor status and time to RA diagnosis. Total cholesterol had no significant impact on the risk of RA in men (OR 1.03; 95 % CI 0.83-1.26). Triglycerides did not predict RA in men or women.

CONCLUSIONS

A high total cholesterol was a risk factor for RA in women but not in men. This suggests that sex-specific exposures modify the impact of lipids on the risk of RA. Hormone-related metabolic pathways may contribute to RA development.

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  • Authors+Show Affiliations

    ,

    Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Inga-Marie Nilssons gata 32, Malmö, 205 02, Sweden. carl.turesson@med.lu.se. Department of Rheumatology, Skåne University Hospital, Inga-Marie Nilssons gata 32, 205 02, Malmö, Sweden. carl.turesson@med.lu.se.

    ,

    Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Inga-Marie Nilssons gata 32, Malmö, 205 02, Sweden. pwf626s@tninet.se. Department of Rheumatology, Skåne University Hospital, Inga-Marie Nilssons gata 32, 205 02, Malmö, Sweden. pwf626s@tninet.se.

    ,

    Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Inga-Marie Nilssons gata 32, Malmö, 205 02, Sweden. mitra.pikwer@med.lu.se. Department of Rheumatology, Eskilstuna Hospital, Kungsvägen 34, Eskilstuna, 631 88, Sweden. mitra.pikwer@med.lu.se.

    ,

    Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Inga-Marie Nilssons gata 32, Malmö, 205 02, Sweden. jan-ake.nilsson@med.lu.se. Department of Rheumatology, Skåne University Hospital, Inga-Marie Nilssons gata 32, 205 02, Malmö, Sweden. jan-ake.nilsson@med.lu.se.

    Rheumatology, Department of Clinical Sciences, Malmö, Lund University, Inga-Marie Nilssons gata 32, Malmö, 205 02, Sweden. lennart.jacobsson@med.lu.se. Department of Rheumatology and Inflammation Research, The Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, Gothenburg, 413 46, Sweden. lennart.jacobsson@med.lu.se.

    Source

    Arthritis research & therapy 17: 2015 Oct 12 pg 284

    MeSH

    Adult
    Aged, 80 and over
    Arthritis, Rheumatoid
    Case-Control Studies
    Cholesterol
    Female
    Humans
    Hypercholesterolemia
    Male
    Middle Aged
    Prospective Studies
    Risk Factors
    Sex Factors
    Triglycerides

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26458977

    Citation

    Turesson, Carl, et al. "High Serum Cholesterol Predicts Rheumatoid Arthritis in Women, but Not in Men: a Prospective Study." Arthritis Research & Therapy, vol. 17, 2015, p. 284.
    Turesson C, Bergström U, Pikwer M, et al. High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study. Arthritis Res Ther. 2015;17:284.
    Turesson, C., Bergström, U., Pikwer, M., Nilsson, J. Å., & Jacobsson, L. T. (2015). High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study. Arthritis Research & Therapy, 17, p. 284. doi:10.1186/s13075-015-0804-1.
    Turesson C, et al. High Serum Cholesterol Predicts Rheumatoid Arthritis in Women, but Not in Men: a Prospective Study. Arthritis Res Ther. 2015 Oct 12;17:284. PubMed PMID: 26458977.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - High serum cholesterol predicts rheumatoid arthritis in women, but not in men: a prospective study. AU - Turesson,Carl, AU - Bergström,Ulf, AU - Pikwer,Mitra, AU - Nilsson,Jan-Åke, AU - Jacobsson,Lennart Th, Y1 - 2015/10/12/ PY - 2015/06/08/received PY - 2015/09/25/accepted PY - 2015/10/14/entrez PY - 2015/10/16/pubmed PY - 2016/8/17/medline SP - 284 EP - 284 JF - Arthritis research & therapy JO - Arthritis Res. Ther. VL - 17 N2 - INTRODUCTION: Environmental exposures, including smoking, hormone-related factors, and metabolic factors, have been implicated in the etiology of rheumatoid arthritis (RA). A previous study has indicated that blood lipid levels may influence the development of RA. The objective of this study was to investigate the impact of serum total cholesterol and triglycerides on the risk of RA in a prospective study. METHODS: Among participants in a large population-based health survey (n = 33,346), individuals who subsequently developed RA were identified by linkage to four different registers and a structured review of the medical records. In a nested case-control study, with controls, matched for age, sex, and year of inclusion, from the health survey database, the relation between serum lipids (levels of total cholesterol and triglycerides) and future RA development was examined. RESULTS: In total, 290 individuals (151 men and 139 women) whose RA was diagnosed a median of 12 years (range of 1-28) after inclusion in the health survey were compared with 1160 controls. Women with a diagnosis of RA during the follow-up had higher total cholesterol levels at baseline compared with controls: odds ratio (OR) 1.54 per standard deviation; 95 % confidence interval (CI) 1.22-1.94. This association remained statistically significant in multivariate models adjusted for smoking and a history of early menopause and in analyses stratified by rheumatoid factor status and time to RA diagnosis. Total cholesterol had no significant impact on the risk of RA in men (OR 1.03; 95 % CI 0.83-1.26). Triglycerides did not predict RA in men or women. CONCLUSIONS: A high total cholesterol was a risk factor for RA in women but not in men. This suggests that sex-specific exposures modify the impact of lipids on the risk of RA. Hormone-related metabolic pathways may contribute to RA development. SN - 1478-6362 UR - https://www.unboundmedicine.com/medline/citation/26458977/full_citation L2 - https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-015-0804-1 DB - PRIME DP - Unbound Medicine ER -