RESEARCH - Anti-CCP antibody, smoking, alcohol consumption and disease duration as risk factors for EAM in RA

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J Rheumatol. 2008 May 1

Anti-Cyclic Citrullinated Peptide Antibody, Smoking, Alcohol

Consumption, and Disease Duration as Risk Factors for Extraarticular

Manifestations in Korean Patients with Rheumatoid Arthritis.

Kim SK, Park SH, Shin IH, Choe JY.

From the Department of Internal Medicine and Department of Medical

Statistics, Catholic University of Daegu School of Medicine, Daegu,

South Korea.

OBJECTIVE: We examined the prevalence of extraarticular manifestations

(EAM) in Korean patients with rheumatoid arthritis (RA). Risk factors

for development of EAM were identified from patients' general

characteristics and clinical or laboratory data.METHODS: Using a

retrospective medical record review, 405 patients, who fulfilled the

American College of Rheumatology 1987 criteria for RA, were

consecutively enrolled. EAM such as serositis, vasculitis, neuropathy,

ocular lesions, sicca symptoms, pulmonary fibrosis, cervical

myelopathy, and rheumatoid nodules were assessed. Statistical analysis

was performed using a chi-square test, Fisher's exact test, 2-sample

t-test, and multivariate logistic regression analysis. RESULTS: The

overall prevalence of EAM in our patients was estimated to be 21.5% (n

= 87). The most common EAM was rheumatoid nodule (8.4%, n = 34).

Univariate analysis revealed anti-cyclic citrullinated peptide

(anti-CCP) antibody positivity, smoking, alcohol consumption, and

disease duration to be the risk factors associated with development of

EAM. Multivariate logistic regression analysis also revealed a

positive anti-CCP antibody, smoking, alcohol consumption, and disease

duration to be closely associated with the development of EAM (p =

0.003, OR 5.006, 95% CI 1.729-14.494; p = 0.002, OR 5.260, 95% CI

1.876-14.753; p = 0.001, OR 0.218, 95% CI 0.086-0.553; p < 0.001, OR

1.061, 95% CI 1.032-1.091, respectively).

CONCLUSION: The prevalence of EAM in Korean RA patients is lower than

in European, North American, and Mediterranean populations. Longer

disease duration, smoking history, and positive anti-CCP antibody

contributed significantly to the occurrence of EAM. Alcohol

consumption in patients with RA had a negative association with EAM.

PMID: 18464311

http://www.ncbi.nlm.nih.gov/pubmed/18464311

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