RESEARCH - Blood transfusion, smoking, and obesity as risk factors for the development of RA

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Blood transfusion, smoking, and obesity as risk factors for the

development of rheumatoid arthritis: results from a primary care-based

incident case-control study in Norfolk,

England.

Symmons, DP, Bankhead, CR, on, BJ, Brennan, P, Barrett, EM,

, DG, and Silman, AJ (1997).

Arthritis Rheum, 40(11):1955-61.

Abstract

OBJECTIVE: To examine a range of demographic, social, and clinical

risk factors for the development of rheumatoid arthritis (RA).

METHODS: Population-based case-control study in Norfolk, England,

involving adult patients, ages 18-70, with an inflammatory

polyarthritis of <12 months’ duration who were recruited from the

Norfolk Arthritis Register. Controls, matched for sex and date of

birth, were selected from the primary care register of the Norwich

Health Authority. Both cases and controls completed identical

self-administered questionnaires. Matched analysis of the 165

case-control sets was conducted for the whole group and for the subset

in which the cases satisfied the 1987 American College of Rheumatology

criteria for RA.

RESULTS: The controls were of higher socioeconomic status than the

cases. This was probably due to response bias. Having a body mass

index > or =30 was associated with an adjusted odds ratio (OR) of 3.74

for developing RA (95% confidence interval [95% CI] 1.14-12.27). RA

was also associated with a history of blood transfusion (OR 4.83, 95%

CI 1.29-18.07). Even after correcting for social class, a history of

having ever smoked was associated with a higher risk of developing RA

(OR 1.66, 95% CI 0.95-3.06). There was no difference between cases and

controls in previous exposure to childhood infections, certain

surgical procedures, or reproductive history variables.

CONCLUSION: RA has a number of potential environmental triggers,

including smoking, obesity, and blood transfusion.

http://pcerg.ceu.ox.ac.uk/bibliography/92/blood-transfusion-smoking-and-obesity-\

as-risk-factors-for-the-development-of-rheumatoid-arthritis-results-from-a-prima\

ry-care-based-incident-case-control-study-in-norfolk-england

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