Moderate Alcohol Intake May Lower the Risk of Rheumatoid Arthritis

Few prospective cohort studies have included an adequate number of cases to test the association of alcohol consumption with the development of rheumatoid arthritis (RA). This large meta-analysis related alcohol consumption to the diagnosis of RA in 1878 subjects, based on prospective data from 5 cohort studies and 3 nested case-control studies.

• Overall, subjects reporting low-to-moderate alcohol consumption (<15 g in a day) had a lower risk of RA (relative risk [RR], 0.86) than abstainers.
• Compared with no alcohol consumption, the adjusted RR was 0.93 for 3 g of alcohol in a day; 0.86 for 9 g in a day; 0.88 for 12 g in a day; 0.91 for 15 g in a day; and 1.28 for 30 g in a day, with stronger effects among women.
• Subgroup analysis indicated that consistent low-to-moderate alcohol consumption for a period of at least 10 years was found to have a 17% reduction in RA risk for both men and women.

Comments:

This study concludes that moderate alcohol consumption is inversely associated with the development of RA. It suggests a “J-shaped” curve, with a lowered risk for an average intake of up to 15 g in a day in comparison with abstainers, and an increased risk with heavier drinking. Down-regulation of the immune response and a decrease in pro-inflammatory cytokines is the probable mechanism of alcohol’s protective effect on the risk of RA, though the increased risk at higher levels remains unexplained.

R. Curtis Ellison, MD

Reference:

Jin Z, Xiang C, Cai Q, et al. Alcohol consumption as a preventive factor for developing rheumatoid arthritis: a dose-response meta-analysis of prospective studies. Ann Rheum Dis. July 29, 2013 [Epub ahead of print]. doi: 10.1136/annrheumdis-2013-203323.