title: Serum selenium, serum alpha-tocopherol, and the risk of rheumatoid arthritis.
abstract: Antioxidant micronutrients have been hypothesized to provide protection against rheumatoid arthritis. We investigated serum selenium and serum alpha-tocopherol for their prediction of subsequent development of rheumatoid arthritis in a case-control study nested within a Finnish cohort of 18,709 adult men and women who had neither arthritis nor a history of it at the baseline examination in 1973-1978; by late 1989, 122 had developed rheumatoid arthritis. Of the incident cases, 34 were rheumatoid factor-negative. Three controls per each incident case were individually matched for sex, age, and municipality. Serum selenium and alpha-tocopherol concentrations were measured from stored serum samples collected at baseline. Serum selenium was inversely related to subsequent occurrence of rheumatoid factor-negative but not rheumatoid factor-positive rheumatoid arthritis. The relative risks, adjusted for smoking and serum total cholesterol, for the highest relative to the lowest tertile of serum selenium, were 0.16 [95% confidence interval (CI) = 0.04-0.69] for rheumatoid factor-negative and 0.96 (CI = 0.49-1.90) for rheumatoid factor-positive rheumatoid arthritis. During the first 10 years of follow-up, the relative risk for rheumatoid arthritis for the highest compared with the lowest tertile of serum alpha-tocopherol was 0.44 (CI = 0.19-0.99). No association was found for longer follow-up periods. Low selenium status may be a risk factor for rheumatoid factor-negative rheumatoid arthritis, and low alpha-tocopherol status may be a risk factor for rheumatoid arthritis independently of rheumatoid factor status.
authors.affiliation: National Public Health Institute (KTL), Helsinki, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Knekt
authors.forename: M
authors.initials: M
authors.lastname: Heliövaara
authors.forename: K
authors.initials: K
authors.lastname: Aho
authors.forename: G
authors.initials: G
authors.lastname: Alfthan
authors.forename: J
authors.initials: J
authors.lastname: Marniemi
authors.forename: A
authors.initials: A
authors.lastname: Aromaa
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000209:etiology*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018570:Risk Assessment; D012643:Selenium / Q000097:blood* / Q000494:pharmacology; D014810:Vitamin E / Q000097:blood* / Q000494:pharmacology
chemical_list: D015415:Biomarkers; D014810:Vitamin E; D012643:Selenium