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Anti-Cyclic Citrullinated Peptide Antibody, Smoking, Alcohol Consumption, and Disease Duration as Risk Factors for Extraarticular Manifestations in Korean Patients with Rheumatoid Arthritis

SEONG-KYU KIM, SUNG-HOON PARK, IM-HEE SHIN, and JUNG-YOON CHOE

ABSTRACT.

Objective.
We examined the prevalence of extraarticular manifestations (EAM) in Korean patients with rheumatoid arthritis (RA). Risk factors for development of EAM were identified from patients' general characteristics and clinical or laboratory data.

Methods. Using a retrospective medical record review, 405 patients, who fulfilled the American College of Rheumatology 1987 criteria for RA, were consecutively enrolled. EAM such as serositis, vasculitis, neuropathy, ocular lesions, sicca symptoms, pulmonary fibrosis, cervical myelopathy, and rheumatoid nodules were assessed. Statistical analysis was performed using a chi-square test, Fisher's exact test, 2-sample t-test, and multivariate logistic regression analysis.

Results. The overall prevalence of EAM in our patients was estimated to be 21.5% (n = 87). The most common EAM was rheumatoid nodule (8.4%, n = 34). Univariate analysis revealed anti-cyclic citrullinated peptide (anti-CCP) antibody positivity, smoking, alcohol consumption, and disease duration to be the risk factors associated with development of EAM. Multivariate logistic regression analysis also revealed a positive anti-CCP antibody, smoking, alcohol consumption, and disease duration to be closely associated with the development of EAM (p = 0.003, OR 5.006, 95% CI 1.729-14.494; p = 0.002, OR 5.260, 95% CI 1.876-14.753; p = 0.001, OR 0.218, 95% CI 0.086-0.553; p < 0.001, OR 1.061, 95% CI 1.032-1.091, respectively).

Conclusion. The prevalence of EAM in Korean RA patients is lower than in European, North American, and Mediterranean populations. Longer disease duration, smoking history, and positive anti-CCP antibody contributed significantly to the occurrence of EAM. Alcohol consumption in patients with RA had a negative association with EAM. (J Rheumatol First Release May 1 2008)

Key Indexing Terms:

EXTRAARTICULAR MANIFESTATION
ALCOHOL CONSUMPTION
ANTI-CYCLIC CITRULLINATED PEPTIDE ANTIBODY
SMOKING


From the Department of Internal Medicine and Department of Medical Statistics, Catholic University of Daegu School of Medicine, Daegu, South Korea.

S-K. Kim, MD; S-H. Park, MD, Department of Internal Medicine; I-H. Shin, MD, Department of Medical Statistics; J-Y. Choe, MD, PhD, Department of Internal Medicine.

Address reprint requests to Dr. J-Y. Choe, Department of Internal Medicine, Catholic University of Daegu School of Medicine, 3056-6 Daemyung 4-Dong, Namgu, Daegu 705-718, South Korea. E-mail: jychoe@cu.ac.kr

Accepted for publication January 25, 2008.



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