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Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis

INTRODUCTION: Although previous studies found that cigarette smoking is associated with risk of rheumatoid arthritis (RA), the dose-response relationship remains unclear. This meta-analysis quantitatively summarizes accumulated evidence regarding the association of lifelong exposure to cigarette smo...

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Autores principales: Di Giuseppe, Daniela, Discacciati, Andrea, Orsini, Nicola, Wolk, Alicja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060378/
https://www.ncbi.nlm.nih.gov/pubmed/24594022
http://dx.doi.org/10.1186/ar4498
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author Di Giuseppe, Daniela
Discacciati, Andrea
Orsini, Nicola
Wolk, Alicja
author_facet Di Giuseppe, Daniela
Discacciati, Andrea
Orsini, Nicola
Wolk, Alicja
author_sort Di Giuseppe, Daniela
collection PubMed
description INTRODUCTION: Although previous studies found that cigarette smoking is associated with risk of rheumatoid arthritis (RA), the dose-response relationship remains unclear. This meta-analysis quantitatively summarizes accumulated evidence regarding the association of lifelong exposure to cigarette smoking assessed as pack-years with the risk of RA. METHODS: Relevant studies were identified by a search of MEDLINE and EMBASE from 1966 to October 2013, with no restrictions. Reference lists from retrieved articles were also reviewed. Studies that reported relative risks (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs) for the association between pack-years of cigarette smoking and rheumatoid arthritis were included in a dose-response random-effects meta-regression analysis. RESULTS: We included 3 prospective cohorts and 7 case-control studies in the meta-analysis. They included a total of 4,552 RA cases. There was no indication of heterogeneity (P(heterogeneity) = 0.32) and publication bias did not affect the results. Compared to never smokers, the risk of developing RA increased by 26% (RR = 1.26, 95% CI 1.14 to 1.39) among those who smoked 1 to 10 pack-years and doubled among those with more than 20 pack-years (RR for 21 to 30 pack years = 1.94, 95% CI 1.65 to 2.27). The risk of RA was not increasing further for higher exposure levels (RR for >40 pack-years = 2.07, 95% CI 1.15 to 3.73). The risk of RA was statistically significantly higher among rheumatoid factor (RF)-positive RA cases (RR = 2.47, 95% CI 2.02 to 3.02) compared to RF-negative (RR = 1.58, 95% CI 1.15 to 2.18) when comparing the highest versus lowest category of pack-years for the individual studies. CONCLUSIONS: Lifelong cigarette smoking was positively associated with the risk of RA even among smokers with a low lifelong exposure. The risk of RA did not further increase with an exposure higher than 20 pack-years.
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spelling pubmed-40603782014-06-17 Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis Di Giuseppe, Daniela Discacciati, Andrea Orsini, Nicola Wolk, Alicja Arthritis Res Ther Research Article INTRODUCTION: Although previous studies found that cigarette smoking is associated with risk of rheumatoid arthritis (RA), the dose-response relationship remains unclear. This meta-analysis quantitatively summarizes accumulated evidence regarding the association of lifelong exposure to cigarette smoking assessed as pack-years with the risk of RA. METHODS: Relevant studies were identified by a search of MEDLINE and EMBASE from 1966 to October 2013, with no restrictions. Reference lists from retrieved articles were also reviewed. Studies that reported relative risks (RR) or odds ratio (OR) estimates with 95% confidence intervals (CIs) for the association between pack-years of cigarette smoking and rheumatoid arthritis were included in a dose-response random-effects meta-regression analysis. RESULTS: We included 3 prospective cohorts and 7 case-control studies in the meta-analysis. They included a total of 4,552 RA cases. There was no indication of heterogeneity (P(heterogeneity) = 0.32) and publication bias did not affect the results. Compared to never smokers, the risk of developing RA increased by 26% (RR = 1.26, 95% CI 1.14 to 1.39) among those who smoked 1 to 10 pack-years and doubled among those with more than 20 pack-years (RR for 21 to 30 pack years = 1.94, 95% CI 1.65 to 2.27). The risk of RA was not increasing further for higher exposure levels (RR for >40 pack-years = 2.07, 95% CI 1.15 to 3.73). The risk of RA was statistically significantly higher among rheumatoid factor (RF)-positive RA cases (RR = 2.47, 95% CI 2.02 to 3.02) compared to RF-negative (RR = 1.58, 95% CI 1.15 to 2.18) when comparing the highest versus lowest category of pack-years for the individual studies. CONCLUSIONS: Lifelong cigarette smoking was positively associated with the risk of RA even among smokers with a low lifelong exposure. The risk of RA did not further increase with an exposure higher than 20 pack-years. BioMed Central 2014 2014-03-05 /pmc/articles/PMC4060378/ /pubmed/24594022 http://dx.doi.org/10.1186/ar4498 Text en Copyright © 2014 Di Giuseppe et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Di Giuseppe, Daniela
Discacciati, Andrea
Orsini, Nicola
Wolk, Alicja
Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title_full Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title_fullStr Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title_full_unstemmed Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title_short Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
title_sort cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060378/
https://www.ncbi.nlm.nih.gov/pubmed/24594022
http://dx.doi.org/10.1186/ar4498
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