Alcohol Consumption and Risk of Rheumatoid Arthritis in Women

女性饮酒与类风湿关节炎的风险

• 批准号: 8028747
• 负责人: Bing Lu
• 金额: $ 8.9万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8028747
• 关键词: Alcohol; Consumption; Risk; Rheumatoid; Arthritis

DESCRIPTION (provided by applicant): The etiology of rheumatoid arthritis (RA), a chronic, destructive, debilitating arthritis that disproportionately affects women, remains incompletely understood. It is considered to be a multifactorial disease, resulting from the interaction of both genetic and environmental factors. Epidemiologic research has produced convincing data for strong environmental risk factors, including cigarette smoking, exogenous hormone use and female reproductive factors. Recently, advances in human genetics have identified 22 risk alleles associated with RA. Alcohol use, as an important lifestyle factor, has been associated with reduced risk of RA based on previous case-control studies. However, most case-control studies which ascertained alcohol exposure retrospectively were limited by the recall bias. The only prospective cohort study on alcohol and RA was limited by small number of cases, and used a one time self-reported alcohol measure that may induce misclassification bias of exposure status. Thus well-controlled prospective cohort studies with larger sample size and more accurate alcohol measures are needed. The Nurses' Health Studies (NHS) are among the largest and longest running investigations of factors that influence women's health in the World. Started in 1976 and expanded in 1989, the information provided by the 238,000 dedicated nurse-participants has provided the unique opportunity to study rare diseases such as RA. We propose the following specific aims based on existing NHS data: 1) To investigate the association between alcohol consumption and the development of RA in women after controlling for age, race, cigarette smoking, reproductive factors and exogenous hormone use using entire NHS cohorts. All RA incident cases were confirmed by 2 board-certified rheumatologists according to American College of Rheumatology classification criteria. Alcohol consumption was assessed repeatedly within a semi-quantitative food frequency questionnaire started from 1980 in NHS 1 and 1989 in NHS II to the last cycle of the questionnaire for non-cases and before RA onset for cases. We will use cumulative average alcohol consumption across repeated measures instead of one-time measure to best represent long-term alcohol consumption. 2) To investigate interactions between 22 identified genetic risk alleles for RA and alcohol consumption using a matched case-control subsample with genotyping (500 incident RA cases, 500 matched controls) nested in NHS cohorts. These innovative studies will advance understanding of RA etiology and furnish additional information for RA prevention strategies, and provide potential public health implications how a modifiable lifestyle factor may influence the risk of developing RA. PUBLIC HEALTH RELEVANCE: Alcohol use as an important lifestyle factor may be associated with decreased risk of RA. However, definitive data supporting this association from well-controlled prospective studies are lacking. Findings from this large cohort study will clarify the possible protective effect of alcohol use on risk of RA in women and furnish additional information for RA prevention strategies.

描述（由申请人提供）：类风湿性关节炎（RA）是一种慢性、破坏性、衰弱性关节炎，对女性的影响尤为严重，其病因仍未完全了解。它被认为是一种多因素疾病，是遗传因素和环境因素相互作用的结果。流行病学研究为强烈的环境危险因素（包括吸烟、外源激素的使用和女性生殖因素）提供了令人信服的数据。最近，人类遗传学的进展已经确定了 22 个与 RA 相关的风险等位基因。根据之前的病例对照研究，饮酒作为一个重要的生活方式因素，与 RA 风险降低相关。然而，大多数回顾性确定酒精暴露的病例对照研究都受到回忆偏差的限制。唯一一项关于酒精和 RA 的前瞻性队列研究受到病例数量的限制，并且使用了一次性自我报告的酒精测量方法，可能会导致暴露状态的错误分类偏差。因此，需要进行良好对照的前瞻性队列研究，样本量更大，酒精测量更准确。护士健康研究 (NHS) 是世界上规模最大、持续时间最长的影响女性健康因素的调查之一。该项目始于 1976 年，并于 1989 年得到扩展，238,000 名专门的护士参与者提供的信息为研究 RA 等罕见疾病提供了独特的机会。我们根据现有的 NHS 数据提出以下具体目标：1) 在使用整个 NHS 队列控制年龄、种族、吸烟、生殖因素和外源激素使用后，研究女性饮酒与 RA 发展之间的关联。所有 RA 事件病例均由 2 名经过委员会认证的风湿病专家根据美国风湿病学会分类标准进行确认。从 1980 年 NHS 1 和 1989 年 NHS II 开始，到非病例问卷的最后一个周期和病例 RA 发病前，在半定量食物频率调查问卷中反复评估酒精消耗量。我们将使用重复测量的累积平均酒精消耗量而不是一次性测量值来最好地代表长期酒精消耗量。 2) 使用 NHS 队列中的匹配病例对照子样本（500 例 RA 病例，500 例匹配对照）进行基因分型，研究 22 个已确定的 RA 遗传风险等位基因与饮酒之间的相互作用。这些创新研究将增进对 RA 病因学的了解，为 RA 预防策略提供更多信息，并提供可改变的生活方式因素如何影响患 RA 风险的潜在公共卫生影响。 公共卫生相关性：饮酒作为重要的生活方式因素可能与降低 RA 风险相关。然而，缺乏来自严格控制的前瞻性研究的支持这种关联的明确数据。这项大型队列研究的结果将阐明饮酒对女性患 RA 风险的可能保护作用，并为 RA 预防策略提供更多信息。