SMOKING AND ALCOHOL A RISK IN ARTHRITIS

by Shivani Barve

If you want to avoid living with debilitating rheumatoid arthritis, put out that cigarette. A new Swedish study reports that smoking is a major risk factor for the disease and is associated with the amount of smoking and genotype.

Smoking is a preventable risk factor
The main risk factors for rheumatoid arthritis are generally listed as sex (women are more likely to develop the disease than men are, and there is evidence it is increasing among women), age (usually develops between ages 40 and 60), family history of the disease (you can also inherit a predisposition), and smoking. A recent study from Boston University School of Public Health suggests a vitamin D deficiency may have a role in the disease as well.

Based on previous research that showed smoking and genetic risk factors work together to increase a person’s risk of developing rheumatoid arthritis,

The researchers found that individuals who smoked at least 20 cigarettes daily for at least 20 years were more than 2.5 times as likely to test positive for the antibody called anticitrullinated protein/peptide (ACPA), a substance closely associated with the most common and severe form of rheumatoid arthritis.

In addition, investigators found that smoking accounted for 35 percent of rheumatoid arthritis patients positive for ACPA and 20 percent of the cases overall. Among individuals who were genetically susceptible to rheumatoid arthritis because they carry two copies of a specific allele (HLA-DRB1 SE), smoking was found to be responsible for 55 percent of ACPApositive cases.

A research says that individuals with the genetic marker HLA-DR4 may have an increased risk of developing rheumatoid arthritis. This substance is present in white blood cells and helps the body distinguish between its own cells and unwelcome invaders.

Although individuals cannot do anything about their genetic makeup, they can avoid certain risk factors. As this study shows, smoking is a major risk factor for rheumatoid arthritis, and fortunately, a preventable one. The study’s authors note that in all but the heaviest smokers, stopping smoking can reduce the risk of developing the disease.

Ok, so we all know that smoking tobacco causes lung diseases, including cancers. Now a new study shows a relationship between smoking and rheumatoid arthritis!

About The Study
• The incidence of elderly onset rheumatoid arthritis and the number of cigarettes smoked per day
• The incidence of elderly onset rheumatoid arthritis and how long the individual was a smoker

It was found that the risk of developing rheumatoid arthritis was nearly double for current smokers compared to non-smokers. The risk of developing rheumatoid arthritis appeared lower for former smokers compared to current smokers but higher than for people who never smoked. Women who had stopped smoking at least 10 years prior to the start of the study did not have an increased risk.

Researchers are not certain why smoking increases the risk of rheumatoid arthritis for women. An interaction between smoking and the woman’s immune system and/or estrogen level has been suggested. It is thought that smoking may lower the level of estrogen. It has also been observed that smoking raises the level of rheumatoid factor in the body. Future studies will focus on determining the exact connection between smoking and rheumatoid arthritis.

Cigarette smoking was first identified as a risk factor for osteoporosis more than 20 years ago. Recent studies have shown a direct relationship between tobacco use and decreased bone density.

Analyzing the impact of cigarette smoking on bone health is complicated. It is hard to determine whether a decrease in bone density is due to smoking itself or to other risk factors. For example, in many cases smokers are thinner than nonsmokers, tend to drink more alcohol, may be less physically active, and have poor diets. Women who smoke also tend to have an earlier menopause than nonsmokers. These factors place many smokers at an increased risk for osteoporosis apart from their tobacco use.

In addition, most studies on the effects of smoking suggest that smoking increases the risk of having a fracture. Not all studies support these findings, but evidence is mounting. For example:

• The longer you smoke and the more cigarettes you consume, the greater your risk of fracture in old age
• Smokers who fracture may take longer to heal
• Significant bone loss has been found in older women and men who smoke
• Studies suggests second-hand smoke exposure during youth may increase the risk of developing low bone mass
• Women who smoke often produce less estrogen and tend to experience menopause earlier than nonsmokers
• Quitting smoking appears to reduce the risk of low bone mass and fractures

M e t h o t r e x a t e a n d Rheumatoid Arthritis: Is Alcohol Consumption Safe?
The researchers also found that methotrexate-treated Psoriatic Arthritis patients were at greater risk for liver toxicity than Rheumatoid Arthritis patients treated with methotrexate are.

Rheumatoid Arthritis patients use methotrexate more than any other drug. And many of them consume alcohol.

Alcohol increases the risk of liver damage for people taking methotrexate.
The increased risk of liver damage is significant for people who are drinking alcohol while taking methotrexate. Ideally, you should not drink alcohol if you take methotrexate. At most, with your doctor’s permission.

Chronic alcohol use has been linked to an increase in fractures of the hip, spine, and wrist. Too much alcohol interferes with the balance of calcium in the body. It also affects the production of hormones, which have a protective effect on bone; and of vitamins, which we need to absorb calcium. Excessive alcohol use can also lead to slips and falls.

Talk to your doctor about a bone density test:
Bone mineral density (BMD) tests measure bone density in various sites of the body. These tests can detect osteoporosis before a fracture occurs and can predict your chances of fracturing in the future.