title: Fish consumption and risk of rheumatoid arthritis: a dose-response meta-analysis.
abstract: BACKGROUND
  The association between fish consumption and rheumatoid arthritis (RA) is unclear. The aim of this paper was to summarize the available evidence on the association between fish consumption and risk of RA using a dose-response meta-analysis.
  
  
  METHODS
  Relevant studies were identified by a search of MEDLINE and EMBASE through December 2013, with no restrictions. A random-effects dose-response meta-analysis was conducted to combine study specific relative risks. Potential non-linear relation was investigated using restricted cubic splines. A stratified analysis was conducted by study design.
  
  
  RESULTS
  Seven studies (four case-controls and three prospective cohorts) involving a total of 174 701 participants and 3346 cases were included in the meta-analysis. For each one serving per week increment in fish consumption, the relative risk (RR) of RA was 0.96 (95% confidence interval (CI) 0.91 to 1.01). Results did not change when stratifying by study design. No heterogeneity or publication bias was observed. When fish consumption was modeled using restricted cubic splines, the risk of RA was 20 to 24% lower for 1 up to 3 servings per week of fish (RR =0.76, 95% CI: 0.57 to 1.02) as compared to never consumption.
  
  
  CONCLUSIONS
  Results from this dose-response meta-analysis showed a non-statistically significant inverse association between fish consumption and RA.
authors.forename: Daniela
authors.initials: D
authors.lastname: Di Giuseppe
authors.forename: Alessio
authors.initials: A
authors.lastname: Crippa
authors.forename: Nicola
authors.initials: N
authors.lastname: Orsini
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
mesh_terms: D000818:Animals; D001172:Arthritis, Rheumatoid / Q000139:chemically induced / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005396:Fish Products / Q000032:analysis*; D005399:Fishes; D005506:Food Contamination; D011078:Polychlorinated Biphenyls / Q000506:poisoning; D012307:Risk Factors
chemical_list: D015525:Fatty Acids, Omega-3; D011078:Polychlorinated Biphenyls