Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.


Alcohol Consumption Is Inversely Associated with Risk and Severity of Rheumatoid Arthritis

Maxwell1,  James R., Gowers1,  Isobel R., Moore2,  David J., Wilson1,  Anthony G.

University of Sheffield, Sheffield, United Kingdom
Royal Hallamshire Hospital, Sheffield, Sheffield, United Kingdom

Purpose:

Studies have suggested that consumption of alcohol associates with a lower risk for rheumatoid arthritis (RA), but the effect of alcohol on disease severity has not yet been investigated. Our objectives were to study the association between alcohol consumption, and susceptibility and severity of RA.

Method:

Frequency of alcohol consumption was recorded by patients and controls in a self completed questionnaire. Odds ratios for RA risk were calculated according to alcohol consumption, adjusted for age, gender and smoking status. Median values of all RA severity measures were then calculated according to frequency of alcohol consumption, and the non-parametric trend test was used to assess association. A quantile regression model was used to adjust for potential confounding.

Results:

873 patients with erosive RA, and 1004 healthy controls were included in the study. Risk of RA decreased according to frequency of alcohol consumption, such that non drinkers had an odds ratio for RA of 4.17 (3.01 – 5.77) compared to subjects consuming alcohol on >10 days per month (p for trend <0.0001). All measures of RA severity including C-reactive protein, 28 joint disease activity score, pain visual analogue scale, modified Health Assessment Questionnaire, and modified Larsen score were inversely associated with increasing frequency of alcohol consumption (p for trend, each <0.0001). After adjustment for potential confounders in a multivariate regression model, frequency of alcohol consumption remained significantly and inversely associated with X ray damage (p=0.002).

Conclusion:

This study suggests that alcohol consumption has an inverse and dose related association with both risk and severity of RA, but we would recommend a prospective study to confirm our findings.

Table 1. RA Severity by frequency of alcohol consumption

Severity MarkerFrequency of Alcohol (days/month)P for trend
01–56–10>10 
LS All38 (54)33 (47)29 (45)27 (47)<0.0001
Men41 (44)30 (46)21 (45)19.5 (34)0.004
Women37 (57)33 (47.5)32 (52)30 (54)0.03
ACPA+40 (56)36.5 (50)32 (56)33 (53)0.02
ACPA-27 (52)22.5 (39.5)17.5 (23)16 (35)0.02
DAS28CRP4.29 (1.66)4.01 (1.50)3.82 (1.63)3.72 (1.41)<0.0001
CRP (mg/l)13 (18.6)10 (14.7)8.7 (9.5)8.0 (8.8)<0.0001
Modified HAQ1.0 (0.94)0.75 (0.75)0.5 (0.88)0.63 (0.75)<0.0001
Pain VAS (cm)4.1 (4.5)3.0 (4)3.1 (3.5)2.75 (3.5)<0.0001
The values stated are the median for each severity marker, interquartile range in brackets. LS = Larsen Score. P values are for the non parametric trend test

To cite this abstract, please use the following information:
Maxwell, James R., Gowers, Isobel R., Moore, David J., Wilson, Anthony G.; Alcohol Consumption Is Inversely Associated with Risk and Severity of Rheumatoid Arthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :386
DOI: 10.1002/art.25469

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