Cigarette smoking patterns preceding primary Sjögren's syndrome.


Journal

RMD open
ISSN: 2056-5933
Titre abrégé: RMD Open
Pays: England
ID NLM: 101662038

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 17 07 2020
revised: 20 08 2020
accepted: 09 09 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 1 9 2021
Statut: ppublish

Résumé

Cigarette smoking is a well-established risk factor for several autoimmune diseases, but its role in primary Sjögren's syndrome (pSS) remains unclear. Here, we investigated the association between cigarette smoking and subsequent development of pSS. Information on smoking habits was collected from lifestyle habit questionnaires of patients with pSS (n=815) and a matched control group (n=4425) for a case-control study. Differences in smoking exposure were analysed by conditional logistic regression. Potential interactions between smoking and risk-associated human leucocyte antigens (HLA) were assessed by multivariate regression. The fraction of patients with pSS having ever smoked prior to diagnosis was lower than in controls (OR 0.67, 95% CI 0.55 to 0.81). Current smoking at diagnosis was also less prevalent in cases (OR 0.37, 95% CI 0.26 to 0.53). However, period prevalence of smoking during early adulthood was not statistically different from controls (OR 0.89, 95% CI 0.66 to 1.22) but markedly decreased over time. This was partly due to patients being more prone to stop smoking, starting already 30 years prior to diagnosis (OR 2.01, 95% CI 1.22 to 3.30). Smoking patterns were also stratified by autoantibody status, yielding similar estimates. No interaction effects between HLA-DRB1 haplotypes and smoking were observed. The observed smoking patterns indicate that individuals who develop pSS smoke equally much as the general population during early life but are then more prone to stop. The data can be interpreted as smoking conferring protective effects, or reflecting early symptoms of pSS that affect smoking habits, emphasising the slow, progressive development of the disease.

Sections du résumé

BACKGROUND BACKGROUND
Cigarette smoking is a well-established risk factor for several autoimmune diseases, but its role in primary Sjögren's syndrome (pSS) remains unclear. Here, we investigated the association between cigarette smoking and subsequent development of pSS.
METHODS METHODS
Information on smoking habits was collected from lifestyle habit questionnaires of patients with pSS (n=815) and a matched control group (n=4425) for a case-control study. Differences in smoking exposure were analysed by conditional logistic regression. Potential interactions between smoking and risk-associated human leucocyte antigens (HLA) were assessed by multivariate regression.
RESULTS RESULTS
The fraction of patients with pSS having ever smoked prior to diagnosis was lower than in controls (OR 0.67, 95% CI 0.55 to 0.81). Current smoking at diagnosis was also less prevalent in cases (OR 0.37, 95% CI 0.26 to 0.53). However, period prevalence of smoking during early adulthood was not statistically different from controls (OR 0.89, 95% CI 0.66 to 1.22) but markedly decreased over time. This was partly due to patients being more prone to stop smoking, starting already 30 years prior to diagnosis (OR 2.01, 95% CI 1.22 to 3.30). Smoking patterns were also stratified by autoantibody status, yielding similar estimates. No interaction effects between HLA-DRB1 haplotypes and smoking were observed.
CONCLUSION CONCLUSIONS
The observed smoking patterns indicate that individuals who develop pSS smoke equally much as the general population during early life but are then more prone to stop. The data can be interpreted as smoking conferring protective effects, or reflecting early symptoms of pSS that affect smoking habits, emphasising the slow, progressive development of the disease.

Identifiants

pubmed: 32994363
pii: rmdopen-2020-001402
doi: 10.1136/rmdopen-2020-001402
pmc: PMC7547543
pii:
doi:

Substances chimiques

Autoantibodies 0
Smoke 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Johannes Mofors (J)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Albin Björk (A)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Elina Richardsdotter Andersson (E)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Marika Kvarnström (M)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Helena Forsblad d'Elia (H)

Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden.

Sara Magnusson-Bucher (S)

Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Leonid Padyukov (L)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Ingrid Kockum (I)

Department of Clinical Neuroscience, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Jan Hillert (J)

Department of Clinical Neuroscience, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Per Eriksson (P)

Division of Rheumatology, Department of Clinical Experimental Medicine, Linköping University, Linköping, Sweden.

Thomas Mandl (T)

Department of Clinical Sciences, Malmö, Rheumatology, Lund University, Malmö, Sweden.

Gunnel Nordmark (G)

Department of Medical Sciences, Rheumatology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.

Lars Alfredsson (L)

Department of Clinical Neuroscience, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.

Marie Wahren-Herlenius (M)

Division of Rheumatology, Department of Medicine Solna, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden marie.wahren@ki.se.
Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway.

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