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Hormonal and Reproductive Factors In Relation to the Risk of Rheumatoid Arthritis In Women: A Prospective Cohort Study with 223,526 Participants
32 Pages Posted: 25 May 2023
More...Abstract
Background: This study aimed to examine rheumatoid arthritis (RA) risk associated with hormonal and reproductive factors in women from the large cohort of the UK Biobank.
Methods: Data on hormonal and reproductive factors in women were collected from a prospective cohort of 223,526 UK Biobank participants. Potential relationship between reproductive factors and RA risk was assessed using restricted cubic spline. Hazard ratios (HR) were estimated using Cox proportional-hazard regressions
Findings: During a median follow-up of 12.39 years, 3,313 RA were identified. Age at menarche >14 was associated with a higher RA risk (HR 1.17, 95% CI 1.05-1.30) compared with those of menarche at 13. The multiple-adjusted HR for RA in women who had menopause <47 years was 1.29 (95% CI 1.12-1.48) compared to women who had menopause at age 50. Short reproductive years increased the risk of RA (HR 1.39, 95% CI 1.21-1.59). Compared to those with 2 children, women with ≥4 children were associated with a higher risk of RA (HR 1.18, 95% CI 1.04-1.34). Women with a history of hysterectomy (HR 1.40, 95% CI 1.25-1.56) or oophorectomy (HR 1.21, 95% CI 1.08-1.35) revealed an increased risk of RA compared to those without a history of hysterectomy or oophorectomy. Both HRT use (HR 1.46, 95% CI 1.35-1.57) and HRT duration (HR 1.02, 95% CI 1.01-1.03) were associated with a higher risk of RA.
Interpretation: Later menarche, ≥4 children, early menopause, short reproductive years, the use of HRT, hysterectomy and oophorectomy are associated with a higher risk of RA.
Funding: This study was funded by grants from the National Natural Science Foundation of China (82273710), Anhui Provincial Natural Science Foundation (2108085Y26, 2108085QH361) and Research Fund of Anhui Institute of Translational Medicine (2021zhyx-B04).
Declaration of Interest: The authors declare no conflict of interest.
Ethical Approval: The UK Biobank has been approved by the Northwest Multicenter Research Ethics Committee (MREC).
Keywords: rheumatoid arthritis, hormonal factor, reproductive factors, UK Biobank, estrogen
Suggested Citation: Suggested Citation