Anthropometric Measures and Risk of Rheumatoid Arthritis in the French E3N Cohort Study

We aimed to assess the relationships between anthropometric measures and risk of rheumatoid arthritis (RA). The E3N cohort included 98,995 women (aged 40–65 years at the recruitment) who completed mailed questionnaires on reproductive factors, lifestyle, and health-related information, including anthropometric measures, every 2–3 years. Cox proportional hazards regression models with age as the time scale and adjusted on known RA risk factors were used to estimate hazard ratios (HRs) and 95% confidence intervals for the risk of incident RA in the overall population (n = 78,452) and after stratification on smoking exposure. Incident RA diagnosis was validated in 698 women. Abdominal obesity (waist circumference >88 cm) was associated with RA (HR = 1.2 (1.0–1.5)), independent of BMI; whereas obesity, defined as BMI ≥ 30 kg/m2, was marginally associated with RA (HR = 1.26 (0.9–1.5), ptrend = 0.0559). Taking lean body shape (BS) as reference, medium BS at puberty (HR = 1.3 (1.0–1.7)) and medium-large BS at perimenopausal period (HR = 1.5 (1.1–1.9)) were associated with the risk of RA among never-smoker women, independent of BMI. Regarding BS trajectory, taking constantly lean BS as reference, constantly large BS from puberty to perimenopause was associated with RA among non-smokers (HR = 2.10 (1.2–3.6)), independent of BMI

Associations between female hormonale exposures, anthropometric measures and rheumatoid arthritis in E3N cohort

La polyarthrite rhumatoïde (PR) est une maladie rhumatismale de physiopathologie complexe, où l'interaction entre agents environnementaux et facteurs génétiques est susceptible de déclencher l'auto-immunité. A ce jour, seul le tabac, chez des patients génétiquement prédisposés, a été rapporté comme associé de façon reproductible au risque de PR. Bien que l'implication des hormones féminines soit vraisemblable, au vu des taux d'incidence plus élevés chez la femme que chez l'homme, les données de la littérature sont discordantes. Différentes études rapportent aussi une association entre excès pondéral et le risque de PR le plus souvent séronégative et chez les femmes. Dans ces études, seul l'indice de masse corporel est utilisé, bien qu'il ne représente pas la répartition corporelle du tissu adipeux qui semble être un élément plus important que l'excès de masse grasse lui-même.Les objectifs de ce projet doctoral étaient d'étudier les associations entre les expositions hormonales, les mesures anthropométriques et le risque de PR dans la cohorte prospective française E3N comptant 98 995 femmes dont 698 PR incidentes.Nos résultats suggèrent qu'un haut niveau d'expositions cumulées aux hormones féminines endogènes et exogènes tout au long de la vie des femmes est inversement associé au risque de survenue d'une PR après la ménopausées. Une trajectoire de silhouette constamment large de la puberté jusqu'à la péri-ménopause est associée à une augmentation de risque de PR chez les femmes non exposées au tabac.Ce projet a ainsi permis d'affiner les connaissances sur les impacts des expositions hormonales féminines cumulées et de la répartition du tissu adipeux sur le risque de PR. Nos résultats soutiennent aussi l'hypothèse selon laquelle les expositions, survenant tôt dans la vie, cumulées et persistantes sont impliquées dans la physiopathologie de la PR. Ces nouvelles données sur la distribution du tissu adipeux à des périodes charnières de la vie reproductive des femmes (puberté et ménopause) mettent en lumière les relations complexes entre fonctions adipocytaires, hormones sexuelles et réponses immunitaires.Rheumatoid arthritis (RA) is a rheumatic disease with a complex pathophysiology. Both environmental and genetic factors are thought to interact in the pathogenesis by triggering autoimmunity. To date, only smoking has been reproducibly reported as a risk factor for RA, particularly in genetically prone patients. Although the implication of female hormones in the pathogenesis of RA is supported by an incidence rate higher in women than in men, published data remain controversial. Several studies report that overweight/obesity is associated with RA especially seronegative and in women. In all these studies, body mass index has been the preferred measure of body fat, although it does not reflect fat distribution and visceral fat.The objectives of this doctoral project were to assess the associations between endogenous and exogenous hormonal exposures, anthropometric measures and risk of RA in the E3N prospective cohort of 98,995 french women included 698 incident RA.Our results suggest that a high level of cumulative exposures to endogenous and exogenous female hormones throughout life is associated with a decreased risk of post-menauposal RA. A body shape trajectory constantly large from puberty to peri-menopause is associated with an increased risk of RA among women never exposed to smoking.This project has improved our knownledges on the impact of female hormonal exposures and fat distribution on the risk of RA. Our results also support the hypothesis that cumulative exposures, occurring early in life and persistent, are involved in the pathophysiology of RA. These new data on the distribution of fat tissue at the pivotal periods of women's reproductive life (puberty and menopause) emphaze the complex relationships between adipocyte functions, sex hormones and immune responses

Etude des associations entre expositions hormonales féminines, mesures anthropométriques et le risque de polyarthrite rhumatoïde dans la cohorte E3N

Rheumatoid arthritis (RA) is a rheumatic disease with a complex pathophysiology. Both environmental and genetic factors are thought to interact in the pathogenesis by triggering autoimmunity. To date, only smoking has been reproducibly reported as a risk factor for RA, particularly in genetically prone patients. Although the implication of female hormones in the pathogenesis of RA is supported by an incidence rate higher in women than in men, published data remain controversial. Several studies report that overweight/obesity is associated with RA especially seronegative and in women. In all these studies, body mass index has been the preferred measure of body fat, although it does not reflect fat distribution and visceral fat.The objectives of this doctoral project were to assess the associations between endogenous and exogenous hormonal exposures, anthropometric measures and risk of RA in the E3N prospective cohort of 98,995 french women included 698 incident RA.Our results suggest that a high level of cumulative exposures to endogenous and exogenous female hormones throughout life is associated with a decreased risk of post-menauposal RA. A body shape trajectory constantly large from puberty to peri-menopause is associated with an increased risk of RA among women never exposed to smoking.This project has improved our knownledges on the impact of female hormonal exposures and fat distribution on the risk of RA. Our results also support the hypothesis that cumulative exposures, occurring early in life and persistent, are involved in the pathophysiology of RA. These new data on the distribution of fat tissue at the pivotal periods of women's reproductive life (puberty and menopause) emphaze the complex relationships between adipocyte functions, sex hormones and immune responses.La polyarthrite rhumatoïde (PR) est une maladie rhumatismale de physiopathologie complexe, où l'interaction entre agents environnementaux et facteurs génétiques est susceptible de déclencher l'auto-immunité. A ce jour, seul le tabac, chez des patients génétiquement prédisposés, a été rapporté comme associé de façon reproductible au risque de PR. Bien que l'implication des hormones féminines soit vraisemblable, au vu des taux d'incidence plus élevés chez la femme que chez l'homme, les données de la littérature sont discordantes. Différentes études rapportent aussi une association entre excès pondéral et le risque de PR le plus souvent séronégative et chez les femmes. Dans ces études, seul l'indice de masse corporel est utilisé, bien qu'il ne représente pas la répartition corporelle du tissu adipeux qui semble être un élément plus important que l'excès de masse grasse lui-même.Les objectifs de ce projet doctoral étaient d'étudier les associations entre les expositions hormonales, les mesures anthropométriques et le risque de PR dans la cohorte prospective française E3N comptant 98 995 femmes dont 698 PR incidentes.Nos résultats suggèrent qu'un haut niveau d'expositions cumulées aux hormones féminines endogènes et exogènes tout au long de la vie des femmes est inversement associé au risque de survenue d'une PR après la ménopausées. Une trajectoire de silhouette constamment large de la puberté jusqu'à la péri-ménopause est associée à une augmentation de risque de PR chez les femmes non exposées au tabac.Ce projet a ainsi permis d'affiner les connaissances sur les impacts des expositions hormonales féminines cumulées et de la répartition du tissu adipeux sur le risque de PR. Nos résultats soutiennent aussi l'hypothèse selon laquelle les expositions, survenant tôt dans la vie, cumulées et persistantes sont impliquées dans la physiopathologie de la PR. Ces nouvelles données sur la distribution du tissu adipeux à des périodes charnières de la vie reproductive des femmes (puberté et ménopause) mettent en lumière les relations complexes entre fonctions adipocytaires, hormones sexuelles et réponses immunitaires

Etude des associations entre expositions hormonales féminines, mesures anthropométriques et le risque de polyarthrite rhumatoïde dans la cohorte E3N

Rheumatoid arthritis (RA) is a rheumatic disease with a complex pathophysiology. Both environmental and genetic factors are thought to interact in the pathogenesis by triggering autoimmunity. To date, only smoking has been reproducibly reported as a risk factor for RA, particularly in genetically prone patients. Although the implication of female hormones in the pathogenesis of RA is supported by an incidence rate higher in women than in men, published data remain controversial. Several studies report that overweight/obesity is associated with RA especially seronegative and in women. In all these studies, body mass index has been the preferred measure of body fat, although it does not reflect fat distribution and visceral fat.The objectives of this doctoral project were to assess the associations between endogenous and exogenous hormonal exposures, anthropometric measures and risk of RA in the E3N prospective cohort of 98,995 french women included 698 incident RA.Our results suggest that a high level of cumulative exposures to endogenous and exogenous female hormones throughout life is associated with a decreased risk of post-menauposal RA. A body shape trajectory constantly large from puberty to peri-menopause is associated with an increased risk of RA among women never exposed to smoking.This project has improved our knownledges on the impact of female hormonal exposures and fat distribution on the risk of RA. Our results also support the hypothesis that cumulative exposures, occurring early in life and persistent, are involved in the pathophysiology of RA. These new data on the distribution of fat tissue at the pivotal periods of women's reproductive life (puberty and menopause) emphaze the complex relationships between adipocyte functions, sex hormones and immune responses.La polyarthrite rhumatoïde (PR) est une maladie rhumatismale de physiopathologie complexe, où l'interaction entre agents environnementaux et facteurs génétiques est susceptible de déclencher l'auto-immunité. A ce jour, seul le tabac, chez des patients génétiquement prédisposés, a été rapporté comme associé de façon reproductible au risque de PR. Bien que l'implication des hormones féminines soit vraisemblable, au vu des taux d'incidence plus élevés chez la femme que chez l'homme, les données de la littérature sont discordantes. Différentes études rapportent aussi une association entre excès pondéral et le risque de PR le plus souvent séronégative et chez les femmes. Dans ces études, seul l'indice de masse corporel est utilisé, bien qu'il ne représente pas la répartition corporelle du tissu adipeux qui semble être un élément plus important que l'excès de masse grasse lui-même.Les objectifs de ce projet doctoral étaient d'étudier les associations entre les expositions hormonales, les mesures anthropométriques et le risque de PR dans la cohorte prospective française E3N comptant 98 995 femmes dont 698 PR incidentes.Nos résultats suggèrent qu'un haut niveau d'expositions cumulées aux hormones féminines endogènes et exogènes tout au long de la vie des femmes est inversement associé au risque de survenue d'une PR après la ménopausées. Une trajectoire de silhouette constamment large de la puberté jusqu'à la péri-ménopause est associée à une augmentation de risque de PR chez les femmes non exposées au tabac.Ce projet a ainsi permis d'affiner les connaissances sur les impacts des expositions hormonales féminines cumulées et de la répartition du tissu adipeux sur le risque de PR. Nos résultats soutiennent aussi l'hypothèse selon laquelle les expositions, survenant tôt dans la vie, cumulées et persistantes sont impliquées dans la physiopathologie de la PR. Ces nouvelles données sur la distribution du tissu adipeux à des périodes charnières de la vie reproductive des femmes (puberté et ménopause) mettent en lumière les relations complexes entre fonctions adipocytaires, hormones sexuelles et réponses immunitaires

Etude des associations entre expositions hormonales féminines, mesures anthropométriques et le risque de polyarthrite rhumatoïde dans la cohorte E3N

Rheumatoid arthritis (RA) is a rheumatic disease with a complex pathophysiology. Both environmental and genetic factors are thought to interact in the pathogenesis by triggering autoimmunity. To date, only smoking has been reproducibly reported as a risk factor for RA, particularly in genetically prone patients. Although the implication of female hormones in the pathogenesis of RA is supported by an incidence rate higher in women than in men, published data remain controversial. Several studies report that overweight/obesity is associated with RA especially seronegative and in women. In all these studies, body mass index has been the preferred measure of body fat, although it does not reflect fat distribution and visceral fat.The objectives of this doctoral project were to assess the associations between endogenous and exogenous hormonal exposures, anthropometric measures and risk of RA in the E3N prospective cohort of 98,995 french women included 698 incident RA.Our results suggest that a high level of cumulative exposures to endogenous and exogenous female hormones throughout life is associated with a decreased risk of post-menauposal RA. A body shape trajectory constantly large from puberty to peri-menopause is associated with an increased risk of RA among women never exposed to smoking.This project has improved our knownledges on the impact of female hormonal exposures and fat distribution on the risk of RA. Our results also support the hypothesis that cumulative exposures, occurring early in life and persistent, are involved in the pathophysiology of RA. These new data on the distribution of fat tissue at the pivotal periods of women's reproductive life (puberty and menopause) emphaze the complex relationships between adipocyte functions, sex hormones and immune responses.La polyarthrite rhumatoïde (PR) est une maladie rhumatismale de physiopathologie complexe, où l'interaction entre agents environnementaux et facteurs génétiques est susceptible de déclencher l'auto-immunité. A ce jour, seul le tabac, chez des patients génétiquement prédisposés, a été rapporté comme associé de façon reproductible au risque de PR. Bien que l'implication des hormones féminines soit vraisemblable, au vu des taux d'incidence plus élevés chez la femme que chez l'homme, les données de la littérature sont discordantes. Différentes études rapportent aussi une association entre excès pondéral et le risque de PR le plus souvent séronégative et chez les femmes. Dans ces études, seul l'indice de masse corporel est utilisé, bien qu'il ne représente pas la répartition corporelle du tissu adipeux qui semble être un élément plus important que l'excès de masse grasse lui-même.Les objectifs de ce projet doctoral étaient d'étudier les associations entre les expositions hormonales, les mesures anthropométriques et le risque de PR dans la cohorte prospective française E3N comptant 98 995 femmes dont 698 PR incidentes.Nos résultats suggèrent qu'un haut niveau d'expositions cumulées aux hormones féminines endogènes et exogènes tout au long de la vie des femmes est inversement associé au risque de survenue d'une PR après la ménopausées. Une trajectoire de silhouette constamment large de la puberté jusqu'à la péri-ménopause est associée à une augmentation de risque de PR chez les femmes non exposées au tabac.Ce projet a ainsi permis d'affiner les connaissances sur les impacts des expositions hormonales féminines cumulées et de la répartition du tissu adipeux sur le risque de PR. Nos résultats soutiennent aussi l'hypothèse selon laquelle les expositions, survenant tôt dans la vie, cumulées et persistantes sont impliquées dans la physiopathologie de la PR. Ces nouvelles données sur la distribution du tissu adipeux à des périodes charnières de la vie reproductive des femmes (puberté et ménopause) mettent en lumière les relations complexes entre fonctions adipocytaires, hormones sexuelles et réponses immunitaires

Le syndrome de Sjogren associé à la sclerodermie

ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Hormonal replacement therapy may reduce the risk for RA in women with early arthritis who carry HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP: results from the ESPOIR cohort.

International audienceOBJECTIVE: To assess the effect of reproductive factors, especially hormone replacement therapy (HRT) and its interaction with HLA-DRB1 *01 and/or *04 alleles on the diagnosis of rheumatoid arthritis (RA) and the presence of anti-cyclic citrullinated peptide (CCP) antibodies in women included in the ESPOIR cohort (early arthritis cohort). METHODS: 568 patients were included in the analyses, which were performed using logistic regression. RESULTS: HRT reduced the risk of RA due to the HLA-DRB1 *01 and/or *04 alleles from OR 1.88 (95% CI 1.32 to 2.68, p<0.000) for HLA-DRB1 *01 and/or *04 alleles alone to OR 1.07 (95% CI 0.51 to 2.26, p=0.85) in women with HLA-DRB1 *01 and/or *04 alleles who received HRT. One explanation might be the protective effect of HRT on the presence of anti-CCP antibodies (OR 0.43, 95% CI 0.24 to 0.77, p<0.006). Other reproductive factors such as the number of pregnancies, menopause and age at menopause, age at menarche and a history of pregnancy with poor outcome were not associated with the diagnosis of RA and the presence of anti-CCP antibodies. CONCLUSION: HRT may reduce the risk of RA due to HLA-DRB1 *01 and/or *04 alleles by protecting against the production of anti-CCP antibodies

Environment and Lifestyle: Their Influence on the Risk of RA

Background: Rheumatoid arthritis (RA) is a complex disease in which environmental agents are thought to interact with genetic factors that lead to triggering of autoimmunity. Methods: We reviewed environmental, hormonal, and dietary factors that have been suggested to be associated with the risk of RA. Results: Smoking is the most robust factor associated with the risk of RA, with a clear gene&ndash;environment interaction. Among other inhalants, silica may increase the risk of RA in men. There is less evidence for pesticides, pollution, and other occupational inhalants. Regarding female hormonal exposures, there is some epidemiological evidence, although not consistent in the literature, to suggest a link between hormonal factors and the risk of RA. Regarding dietary factors, available evidence is conflicting. A high consumption of coffee seems to be associated with an increased risk of RA, whereas a moderate consumption of alcohol is inversely associated with the risk of RA, and there is less evidence regarding other food groups. Dietary pattern analyses (Mediterranean diet, the inflammatory potential of the diet, or diet quality) suggested a potential benefit of dietary modifications for individuals at high risk of RA. Conclusion: To date, smoking and silica exposure have been reproducibly demonstrated to trigger the emergence of RA. However, many other environmental factors have been studied, mostly with a case-control design. Results were conflicting and studies rarely considered potential gene&ndash;environment interactions. There is a need for large scale prospective studies and studies in predisposed individuals to better understand and prevent the disease and its course

Anthropometric Measures and Risk of Rheumatoid Arthritis in the French E3N Cohort Study

We aimed to assess the relationships between anthropometric measures and risk of rheumatoid arthritis (RA). The E3N cohort included 98,995 women (aged 40–65 years at the recruitment) who completed mailed questionnaires on reproductive factors, lifestyle, and health-related information, including anthropometric measures, every 2–3 years. Cox proportional hazards regression models with age as the time scale and adjusted on known RA risk factors were used to estimate hazard ratios (HRs) and 95% confidence intervals for the risk of incident RA in the overall population (n = 78,452) and after stratification on smoking exposure. Incident RA diagnosis was validated in 698 women. Abdominal obesity (waist circumference >88 cm) was associated with RA (HR = 1.2 (1.0–1.5)), independent of BMI; whereas obesity, defined as BMI ≥ 30 kg/m2, was marginally associated with RA (HR = 1.26 (0.9–1.5), ptrend = 0.0559). Taking lean body shape (BS) as reference, medium BS at puberty (HR = 1.3 (1.0–1.7)) and medium-large BS at perimenopausal period (HR = 1.5 (1.1–1.9)) were associated with the risk of RA among never-smoker women, independent of BMI. Regarding BS trajectory, taking constantly lean BS as reference, constantly large BS from puberty to perimenopause was associated with RA among non-smokers (HR = 2.10 (1.2–3.6)), independent of BMI

Fish Consumption and Risk of Rheumatoid Arthritis: Findings from the E3N Cohort Study

Fish consumption has been thought to reduce the risk of rheumatoid arthritis (RA), but the reported data are conflicting. We aimed to assess the association between fish consumption (overall, lean fish, and oily fish) and the risk of RA. The E3N Study is a French prospective cohort study including 98,995 women since 1990. Dietary data were collected via a validated food frequency questionnaire in 1993. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident RA. Models were adjusted for age and for the main potential confounders including cigarette smoking. Among 62,629 women, 480 incident cases of RA were identified. In the overall population, we did not find a linear association between overall fish consumption and RA risk (p for trend 0.65), but a moderate consumption of fish was associated with a decreased risk of RA (HR 0.74; 95% CI 0.59&ndash;0.94 for tertile 2 compared with tertile 1), especially among current or former smokers (HR 0.61; 95% CI 0.44&ndash;0.85). Although not statistically significant, a trend towards an inverse association was only found with oily fish consumption (HR 0.81; 95% CI 0.65&ndash;1.02), but not with lean fish. Our results suggest that moderate fish consumption could reduce the risk or RA and potentially counterbalance the increased risk of RA induced by smoking. This inverse association might be explained by the omega-3 fatty acid content of oily fish