吸烟同时高盐饮食使患类风湿关节炎的风险增高

作者：Bj?rnSundstr?m 翻译：柴静 校正：赵金霞

摘要: 目的：近年来，在动物模型及人类细胞模型中均证明氯化钠能够作用于Th17细胞促进炎症反应。该研究目的为评价氯化钠摄入对类风湿关节炎发生风险的影响。

方法：利用来自V?sterbotten干预项目的基于人群的前瞻性数据进行巢式病例对照研究。该研究共纳入386人，在类风湿关节炎症状出现前平均7.7年时间，作为社区干预项目的一部分，他们会报告他们的饮食习惯。作为比较，共有来自同一数据库的相匹配的1886人作为对照，并共同进行分析。

结果：在所有个体均包含在内时，钠摄入和类风湿关节炎发生无明显关系。对检查时的吸烟状态进行分层分析发现，吸烟者中钠摄入者患类风湿关节炎的风险升高大于2倍[风险比(OR) 2.26 (95% CI 1.06, 4.81)]。而在非吸烟者中并未观察到这一现象。吸烟及高钠摄入的相互作用分析发现从这些暴露因素发展而来的类风湿关节炎中54%是因为他们之间的相互作用[归因比 0.54 (95% CI 0.26, 0.82)]。The risk was further increased for the development of anti-CCP-positive and/or HLA shared epitope–positive RA.抗CCP抗体阳性和/或HLA共享表位阳性的类风湿关节炎患者这种风险进一步增加。

结论：尽管我们不能证实我们所提出的假说，我们的结果—吸烟者高钠饮食与类风湿关节炎发生风险增高有关—可能为吸烟影响类风湿关节炎发生提供了新的视野。

附原文：Abstract Objective： Recent studies in animal models and on human cells have shown an effect of sodium chloride (NaCl) on Th17 cells promoting inflammation. The aim of this study was to evaluate the impact of NaCl intake on the risk of development of RA.Methods： A nested case–control study was performed using population-based prospective data from the V?sterbotten Intervention Programme. The study included 386 individuals who had stated their dietary habits as part of a community intervention programme a median of 7.7 years before the onset of symptoms of RA. For comparison, 1886 matched controls were identified from the same database and co-analysed.Results：No significant association was found between sodium intake and the development of RA when all of the individuals were included. In analyses stratified for smoking status at the time of the examination, sodium intake more than doubled the risk for RA among smokers [odds ratio (OR) 2.26 (95% CI 1.06, 4.81)]. This was not observed among non-smokers. Additive interaction analysis of smoking and cases with the highest tertile of sodium intake revealed that 54% of the increased risk of developing RA from these exposures was due to interaction between them [attributable proportion 0.54 (95% CI 0.26, 0.82)]. The risk was further increased for the development of anti-CCP-positive and/or HLA shared epitope–positive RA.Conclusion ：Although we were unable to confirm our stated hypothesis, our results that high sodium consumption among smokers was associated with the risk of RA may provide new insights into the impact of smoking in RA development.

引自：Bj?rnSundstr?m,IngegerdJohansson,SolbrittRantap??-Dahlqvist.Interaction Between Dietary Sodium and Smoking Increases the Risk for Rheumatoid Arthritis.Rheumatology, 2015, 54(3):487-493.