title: A population-based study on the association between rheumatoid arthritis and voice problems.
abstract: The objective of this study was to investigate whether rheumatoid arthritis increases the frequency of organic laryngeal lesions and the subjective voice complaint rate in those with no organic laryngeal lesion. We performed a cross-sectional study using the data from 19,368 participants (418 rheumatoid arthritis patients and 18,950 controls) of the 2008-2011 Korea National Health and Nutrition Examination Survey. The associations between rheumatoid arthritis and organic laryngeal lesions/subjective voice complaints were analyzed using simple/multiple logistic regression analysis with complex sample adjusting for confounding factors, including age, sex, smoking status, stress level, and body mass index, which could provoke voice problems. Vocal nodules, vocal polyp, and vocal palsy were not associated with rheumatoid arthritis in a multiple regression analysis, and only laryngitis showed a positive association (adjusted odds ratio, 1.59; 95 % confidence interval, 1.01-2.52; P = 0.047). Rheumatoid arthritis was associated with subjective voice discomfort in a simple regression analysis, but not in a multiple regression analysis. Participants with rheumatoid arthritis were older, more often female, and had higher stress levels than those without rheumatoid arthritis. These factors were associated with subjective voice complaints in both simple and multiple regression analyses. Rheumatoid arthritis was not associated with organic laryngeal diseases except laryngitis. Rheumatoid arthritis did not increase the odds ratio for subjective voice complaints. Voice problems in participants with rheumatoid arthritis originated from the characteristics of the rheumatoid arthritis group (higher mean age, female sex, and stress level) rather than rheumatoid arthritis itself.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: J Hun
authors.initials: JH
authors.lastname: Hah
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Thyroid/Head and Neck Cancer Center of the Dongnam Institute of Radiological and Medical Sciences (DIRAMS), Busan, South Korea.
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: An
authors.affiliation: Department of Statistics, Hallym University, Chuncheon, South Korea.
authors.forename: Songyong
authors.initials: S
authors.lastname: Sim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, South Korea.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Oh
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
authors.forename: Bumjung
authors.initials: B
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, Hallym University, Anyang, South Korea.
authors.forename: Sung-Gyun
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea. pupen@naver.com.
authors.forename: Hyo Geun
authors.initials: HG
authors.lastname: Choi
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D056910:Republic of Korea; D064706:Vocal Cord Dysfunction / Q000453:epidemiology*; D014826:Vocal Cord Paralysis / Q000453:epidemiology*; D014831:Voice
keywords: Arthritis, rheumatoid; Vocal cord dysfunction; Vocal cord paralysis; Voice