title: Alcohol consumption and risk of incident rheumatoid arthritis in women: a prospective study.
abstract: OBJECTIVE
  To evaluate the association of alcohol consumption with the risk of rheumatoid arthritis (RA) in 2 large prospective cohorts, the Nurses' Health Study (NHS) and NHSII.
  
  
  METHODS
  The NHS was established in 1976 and enrolled 121,701 female registered nurses in the US. The NHSII began in 1989, enrolling 116,430 female nurses. Lifestyle and environmental exposures were collected through biennial questionnaires. Alcohol consumption was assessed with a food frequency questionnaire, which was completed every 4 years. Incident RA cases were identified using a connective tissue disease screening questionnaire and a medical record review. Separate Cox proportional hazards models were used to estimate hazard ratios (HRs) after adjusting for potential confounders in the NHS and NHSII. The pooled HR from 2 cohorts was estimated using a DerSimonian and Laird random-effects model.
  
  
  RESULTS
  Among 1.90 million person-years from 1980 to 2008, 580 incident cases of RA were diagnosed in the NHS cohort, and among 1.78 million person-years from 1989 to 2009, 323 incident cases of RA were diagnosed in the NHSII cohort. Compared to no use, the pooled multivariable adjusted HR for alcohol use of 5.0-9.9 gm/day was 0.78 (95% confidence interval [95% CI] 0.61-1.00). For seropositive RA cases, the association appeared stronger (HR 0.69 [95% CI 0.50-0.95]). In addition, women who drank beer 2-4 times a week had a 31% decreased risk compared to women who never drank beer.
  
  
  CONCLUSIONS
  We found a modest association between long-term moderate alcohol drinking and reduced risk of RA. Future studies are needed to confirm our findings in other populations.
authors.affiliation: Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Bing
authors.initials: B
authors.lastname: Lu
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
authors.forename: Karen H
authors.initials: KH
authors.lastname: Costenbader
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Karlson
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology*; D001172:Arthritis, Rheumatoid / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
references.citation: Control Clin Trials. 1986 Sep;7(3):177-88
references.pmid: 3802833
references.citation: Ann Rheum Dis. 2012 Mar;71(3):378-81
references.pmid: 21972241
references.citation: Mol Immunol. 2005 May;42(7):811-20
references.pmid: 15829269
references.citation: Am J Epidemiol. 1994 Dec 1;140(11):1016-9
references.pmid: 7985649
references.citation: Atherosclerosis. 2006 May;186(1):113-20
references.pmid: 16055129
references.citation: Arthritis Rheum. 1999 Mar;42(3):415-20
references.pmid: 10088762
references.citation: Arthritis Res Ther. 2006;8(4):R133
references.pmid: 16872514
references.citation: Arthritis Rheum. 2010 Dec;62(12):3554-9
references.pmid: 20827783
references.citation: JAMA. 2011 Nov 2;306(17):1884-90
references.pmid: 22045766
references.citation: Arthritis Rheum. 2004 Nov;50(11):3458-67
references.pmid: 15529351
references.citation: Epidemiology. 1994 Sep;5(5):525-32
references.pmid: 7986867
references.citation: J Rheumatol. 2002 Feb;29(2):246-54
references.pmid: 11838841
references.citation: Am J Med. 2006 Jun;119(6):503.e1-9
references.pmid: 16750964
references.citation: Med Sci Sports Exerc. 1993 Jan;25(1):71-80
references.pmid: 8292105
references.citation: J Infect Dis. 1989 Sep;160(3):422-9
references.pmid: 2668425
references.citation: Ann Rheum Dis. 1990 Dec;49(12):980-2
references.pmid: 2270970
references.citation: Am J Epidemiol. 1999 Mar 15;149(6):531-40
references.pmid: 10084242
references.citation: Alcohol. 2008 Mar;42(2):137-42
references.pmid: 18358993
references.citation: Arthritis Rheum. 1988 Mar;31(3):315-24
references.pmid: 3358796
references.citation: Proc Natl Acad Sci U S A. 2007 Jan 2;104(1):258-63
references.pmid: 17185416
references.citation: Am J Epidemiol. 1985 Jul;122(1):51-65
references.pmid: 4014201
references.citation: J Rheumatol. 2004 Feb;31(2):207-13
references.pmid: 14760786
references.citation: J Natl Cancer Inst. 1988 Oct 5;80(15):1198-202
references.pmid: 3047407
references.citation: Arthritis Rheum. 2010 May;62(5):1265-72
references.pmid: 20213811
references.citation: Ann Rheum Dis. 2006 Sep;65(9):1163-7
references.pmid: 16887863
references.citation: Autoimmun Rev. 2005 Mar;4(3):130-6
references.pmid: 15823498
references.citation: Alcohol Res Health. 2007;30(1):42-3
references.pmid: 17718400
references.citation: Ann Rheum Dis. 2009 Feb;68(2):222-7
references.pmid: 18535114
references.citation: BMJ. 2012 Jul 10;345:e4230
references.pmid: 22782847
references.citation: Br J Rheumatol. 1992 Jun;31(6):365-8
references.pmid: 1596697