Assessment of rheumatoid arthritis and associated risk factors among patients attending Kibungo level two teaching hospital
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, but can affect other parts of the body causing inflammation, pain, stiffness, and joint damage. It affects approximately 1% of the global population. The objectives of this study were to assess the prevalence of rheumatoid arthritis and risk factors associated with rheumatoid arthritis among patients attending Kibungo level two teaching hospital. The retrospective study extracted data from January, 2018 to January 2023 and the cross-sectional part assessed risk factors associated to rheumatoid arthritis using questionnaire by telephone calls. Data collected were analyzed statistically using SPSS version 25. In this study the prevalence of rheumatoid arthritis was 43.20%. Across sex, females were more affected than males (44.2% and 40.0%, respectively). Binary logistic regression was used to assess the association between RA and risk factors. Age groups, C-Reactive Protein, red meat consumption showed significant association with RA (OR = 1.566, p = 0.008; OR = 1.299, p = 0.013; OR = 2.599, p < 0.001). The study was limited since it only included the participants at Kibungo Level two Teaching hospital, hence not having large population. Carrying out country wide studies regarding to the rheumatoid arthritis and associated risk factors on large population in order to establish epidemiologic data in Rwanda is highly recommended.
Keywords: Rheumatoid arthritis, risk factors, C-Reactive Protein, Rheumatoid Factor
Keywords:
Rheumatoid arthritis, risk factors, C-Reactive Protein, Rheumatoid Factor
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References
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22. Sugiyama, D., et al., Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis, 2010; 69(1):70-81. https://doi.org/10.1136/ard.2008.096487 PMid:19174392
23. Chang, K., et al., Smoking and rheumatoid arthritis. Int J Mol Sci, 2014; 15(12):22279-95. https://doi.org/10.3390/ijms151222279 PMid:25479074 PMCid:PMC4284707
24. Pryor, W.A. and K. Stone, Oxidants in cigarette smoke. Radicals, hydrogen peroxide, peroxynitrate, and peroxynitrite. Ann N Y Acad Sci, 1993; 686:12-27; discussion 27-8. https://doi.org/10.1111/j.1749-6632.1993.tb39148.x PMid:8512242
25. Kalpakcioglu, B. and K. Senel, The interrelation of glutathione reductase, catalase, glutathione peroxidase, superoxide dismutase, and glucose-6-phosphate in the pathogenesis of rheumatoid arthritis. Clin Rheumatol, 2008; 27(2):141-5. https://doi.org/10.1007/s10067-007-0746-3 PMid:17912575
26. Di Giuseppe, D., et al., Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study. BMJ : British Medical Journal, 2012; 345:e4230. https://doi.org/10.1136/bmj.e4230 PMid:22782847 PMCid:PMC3393782
27. Grant, W.B., The role of meat in the expression of rheumatoid arthritis. Br J Nutr, 2000; 84(5):589-95. https://doi.org/10.1017/S0007114500001926 PMid:11177171
28. Shiraseb, F., et al., Red, white, and processed meat consumption related to inflammatory and metabolic biomarkers among overweight and obese women. Front Nutr, 2022; 9:1015566. https://doi.org/10.3389/fnut.2022.1015566 PMid:36438769 PMCid:PMC9684714
29. Larsson, S.C. and A. Wolk, Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. Br J Cancer, 2012; 106(3):603-7. https://doi.org/10.1038/bjc.2011.585 PMid:22240790 PMCid:PMC3273353
2. Avci, A.B., E. Feist, and G.R. Burmester, Biologicals in rheumatoid arthritis: current and future. RMD Open, 2015; 1(1):e000127. https://doi.org/10.1136/rmdopen-2015-000127 PMid:26535144 PMCid:PMC4613149
3. Hitchon, C.A., et al., Prevalence and Incidence of Rheumatoid Arthritis in Canadian First Nations and Non-First Nations People: A Population-Based Study. J Clin Rheumatol, 2020; 26(5):169-175. https://doi.org/10.1097/RHU.0000000000001006 PMid:30676383 PMCid:PMC7386864
4. Nikiphorou, E., et al., Cardiovascular risk factors and outcomes in early rheumatoid arthritis: a population-based study. Heart, 2020;106(20):1566-1572. https://doi.org/10.1136/heartjnl-2019-316193 PMid:32209618 PMCid:PMC7525791
5. Almutairi, K., et al., The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int, 2021;41(5):863-877. https://doi.org/10.1007/s00296-020-04731-0 PMid:33175207
6. Al-Dalaan, A., et al., The prevalence of rheumatoid arthritis in the Qassim region of Saudi Arabia. Ann Saudi Med, 1998; 18(5):396-7. https://doi.org/10.5144/0256-4947.1998.396 PMid:17344708
7. Silva-Fernández, L., et al., The prevalence of rheumatoid arthritis in Spain. Sci Rep, 2020; 10(1):21551. https://doi.org/10.1038/s41598-020-76511-6 PMid:33299019 PMCid:PMC7725786
8. Al-Ghamdi, A.A., The co-morbidities and mortality rate among rheumatoid arthritis patients at the western region of Saudi Arabia: a retrospective cross-sectional study. Journal of King Abdulaziz University-Medical Sciences, 2009; 16(3):15-29. https://doi.org/10.4197/Med.16-3.2
9. Albishri, J., et al., Prevalence of RA and SLE in Saudi Arabia. Sch J App Med Sci, 2015; 3:2096-2099.
10. Cutolo, M., et al., Synovial fluid estrogens in rheumatoid arthritis. Autoimmun Rev, 2004; 3(3):193-8. https://doi.org/10.1016/j.autrev.2003.08.003 PMid:15110231
11. Kawasaki, T., et al., Effects of estrogen on interleukin-6 production in rheumatoid fibroblast-like synoviocytes. Clin Exp Rheumatol, 2000; 18(6):743-5.
12. Cutolo, M., et al., Estrogens and autoimmune diseases. Ann N Y Acad Sci, 2006; 1089:538-47. https://doi.org/10.1196/annals.1386.043 PMid:17261796
13. Yu, Z., et al., Level of Estrogen in Females-The Different Impacts at Different Life Stages. J Pers Med, 2022; 12(12). https://doi.org/10.3390/jpm12121995 PMid:36556216 PMCid:PMC9781566
14. Otón, T. and L. Carmona, The epidemiology of established rheumatoid arthritis. Best Pract Res Clin Rheumatol, 2019; 33(5):101477. https://doi.org/10.1016/j.berh.2019.101477 PMid:31987685
15. Lu, B., et al., Being overweight or obese and risk of developing rheumatoid arthritis among women: a prospective cohort study. Ann Rheum Dis, 2014; 73(11):1914-22. https://doi.org/10.1136/annrheumdis-2014-205459 PMid:25057178 PMCid:PMC4207219
16. Voigt, L.F., et al., Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis. Epidemiology, 1994; 5(5):525-32.
17. Symmons, D.P., et al., Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: results from a primary care-based incident case-control study in Norfolk, England. Arthritis Rheum, 1997; 40(11):1955-61. https://doi.org/10.1002/art.1780401106 PMid:9365083
18. Uhlig, T., K.B. Hagen, and T.K. Kvien, Current tobacco smoking, formal education, and the risk of rheumatoid arthritis. J Rheumatol, 1999; 26(1):47-54.
19. Cerhan, J.R., et al., Blood transfusion, alcohol use, and anthropometric risk factors for rheumatoid arthritis in older women. J Rheumatol, 2002; 29(2):246-54.
20. Shrivastava, A.K., et al., Inflammatory markers in patients with rheumatoid arthritis. Allergol Immunopathol (Madr), 2015; 43(1):81-7. https://doi.org/10.1016/j.aller.2013.11.003 PMid:24656623
21. Pope, J.E. and E.H. Choy, C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin Arthritis Rheum, 2021; 51(1):219-229. https://doi.org/10.1016/j.semarthrit.2020.11.005 PMid:33385862
22. Sugiyama, D., et al., Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis, 2010; 69(1):70-81. https://doi.org/10.1136/ard.2008.096487 PMid:19174392
23. Chang, K., et al., Smoking and rheumatoid arthritis. Int J Mol Sci, 2014; 15(12):22279-95. https://doi.org/10.3390/ijms151222279 PMid:25479074 PMCid:PMC4284707
24. Pryor, W.A. and K. Stone, Oxidants in cigarette smoke. Radicals, hydrogen peroxide, peroxynitrate, and peroxynitrite. Ann N Y Acad Sci, 1993; 686:12-27; discussion 27-8. https://doi.org/10.1111/j.1749-6632.1993.tb39148.x PMid:8512242
25. Kalpakcioglu, B. and K. Senel, The interrelation of glutathione reductase, catalase, glutathione peroxidase, superoxide dismutase, and glucose-6-phosphate in the pathogenesis of rheumatoid arthritis. Clin Rheumatol, 2008; 27(2):141-5. https://doi.org/10.1007/s10067-007-0746-3 PMid:17912575
26. Di Giuseppe, D., et al., Long term alcohol intake and risk of rheumatoid arthritis in women: a population based cohort study. BMJ : British Medical Journal, 2012; 345:e4230. https://doi.org/10.1136/bmj.e4230 PMid:22782847 PMCid:PMC3393782
27. Grant, W.B., The role of meat in the expression of rheumatoid arthritis. Br J Nutr, 2000; 84(5):589-95. https://doi.org/10.1017/S0007114500001926 PMid:11177171
28. Shiraseb, F., et al., Red, white, and processed meat consumption related to inflammatory and metabolic biomarkers among overweight and obese women. Front Nutr, 2022; 9:1015566. https://doi.org/10.3389/fnut.2022.1015566 PMid:36438769 PMCid:PMC9684714
29. Larsson, S.C. and A. Wolk, Red and processed meat consumption and risk of pancreatic cancer: meta-analysis of prospective studies. Br J Cancer, 2012; 106(3):603-7. https://doi.org/10.1038/bjc.2011.585 PMid:22240790 PMCid:PMC3273353
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Munezero PC, Mukiza P, Mutijima JB, Kankindi J, Nshimiyimana A, Ishimwe AP, Tuyishime J de D, Sinumvayo JP, Ndayambaje FX, Ndacyayisenga J. Assessment of rheumatoid arthritis and associated risk factors among patients attending Kibungo level two teaching hospital. JDDT [Internet]. 15Sep.2023 [cited 2Oct.2023];13(9):119-24. Available from: https://jddtonline.info/index.php/jddt/article/view/5962
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