Rheumatology and Women's Health: 3 Key Findings

March 2, 2018

Among the highlights of 3 recent studies: insights into hormonal risk factors for rheumatoid arthritis.

References:1. AlpÃzar-RodrÃguez D, Pluchino N, Canny G, et al. The role of female hormonal factors in the development of rheumatoid arthritis. Rheumatology. 2017;56:1254-1263.2. Kok VC, Horng JT, Wang MN, et al. Gout as a risk factor for osteoporosis: epidemiologic evidence from a population-based longitudinal study involving 108,060 individuals. Osteoporos Int. 2018 Jan 30. doi: 10.1007/s00198-018-4375-2. [Epub ahead of print]3. Toral P, Flores MT, Horton R, Rose J. Evaluation of a longstanding telephone peer counseling service on people with systemic lupus erythematosus and their loved ones. Arthritis Rheumatol. 2017;69(suppl 10). Abstract 1861.

Three clinical studies looked at the effects of rheumatoid arthritis (RA), gout, and systemic lupus erythematosus (SLE) on women's health issues.^1-3 What can be gleaned from this research? These key points:
1. Female hormonal factors play a role in the development of RA
2. Gout is a risk factor for osteoporosis
3. A phone support line has a positive impact on patients with SLE

(Pregnant woman: ©Roman Pyshchyk/Shutterstock.com; toe: ©Melodia plus photos/Shutterstock.com; clinician on phone: ©Rocketclips/Shutterstock.com)

A systematic review examined published articles from January 2000 to March 2016.¹ Several studies showed no significant association between specific female hormonal factors and the development of rheumatoid arthritis (RA). Factors related to RA include high levels of estrogen, early menarche, and postpartum stage. On the other hand, factors such as parity, history of pregnancy loss, use of hormone replacement therapy, or oral contraceptives have been found to be both protective and risk factors for the disease. (©Roman Pyshchyk/Shutterstock.com)

"Environmental factors, including female hormonal factors, are responsible for a large proportion of RA risk, and various genetic and environmental factors may interact to increase the risk of disease. Non-hormonal sex-related factors, such as sex chromosomes, microchimerism, or sex differences in the microbiome may also contribute to RA development," stated the researchers, led by DeshirÃ© AlpÃzar-RodrÃguez of the University Hospital of Geneva in Switzerland.

A population-based, retrospective, matched-cohort study included 36,458 patients with gout and 71,602 patients without gout.² Those with gout had significantly higher baseline rates of RA, morbid obesity, smoking-related diagnosis, alcohol use disorder, hypertension, dyslipidemia, diabetes, and kidney disease than people without gout.

A total of 517 patients in the gout cohort and 811 patients in the non-gout cohort received a diagnosis of osteoporosis. The cumulative incidence of osteoporosis was statistically higher in the gout cohort than in the non-gout cohort. A multivariable-adjusted Cox model found gout was associated with a significantly greater hazard ratio for incident osteoporosis (HR, 1.2). (©Melodia plus photos/Shutterstock.com)

"This first population-based epidemiologic study supports the hypothesis that compared with individuals without gout, those with gout have a modest increase in the risk of developing osteoporosis in the future," stated the researchers, led by Victor Kok of Kuang Tien General Hospital in Taichung, Taiwan.

A 60-item survey was administered to callers with systemic lupus erythematosus (SLE) who had been matched with a peer counselor between 2015 and 2017. Information was collected on demographics, satisfaction with the screening process and peer counselors, lupus management, coping, and the overall impact of the service. Of the 32 patients with SLE who had called, 23 responded.³

Some 68% of the responders indicated that their initial reason for calling was to seek emotional support, as well as lupus education and resources. The vast majority of respondents (95%) indicated that their expectations were met. About three-quarters (72%) stated that having someone knowledgeable about lupus was the most valuable aspect of the call. (©Rocketclips/Shutterstock.com)

"Lupus can be very isolating. Friends and families may not understand the illness, so it's very valuable for the caller to have a peer counselor, someone with similar experiences, who will listen and help to guide them," said senior author Jillian Rose of the Hospital for Special Surgery in New York.