Re­ports: more women are get­ting rheuma­toid arthri­tis

The Covington News - - Society - Kir­ven Week­ley Colum­nist C. Kir­ven Week­ley, Ph. D. is a clin­i­cal psy­chol­o­gist with of­fices in Cov­ing­ton and Nor­cross. He spe­cial­izes in the eval­u­a­tion and treat­ment of adults for de­pres­sion, anx­i­ety, re­la­tion­ship prob­lems and med­i­cal is­sues. He can be r

Ac­cord­ing to a re­cent study from the Mayo Clinic, rheuma­toid arthri­tis ( RA) in women has in­creased be­tween the years 1995 and 2007. This rise fol­lows a four year de­cline in the dis­ease and is spec­u­lated to be ef­fected by en­vi­ron­men­tal fac­tors such as cig­a­rette smok­ing, vi­ta­min D de­fi­ciency and lower dose syn­thetic es­tro­gens in oral con­tra­cep­tives.

The Mayo Clinic study was pub­lished in June in the jour­nal Arthri­tis and Rheuma­tism and in­cluded over 50 years of epi­demi­o­log­i­cal data. RA is a chronic in­flam­ma­tory dis­ease that attacks skele­tal joints, ef­fect­ing be­tween 1 mil­lion and 2 mil­lion Amer­i­cans. Peo­ple with RA usu­ally be­come un­able to work within 10 to 20 years and have a 60 per­cent to 70 per­cent higher mor­tal­ity risk than the gen­eral pop­u­la­tion. Treat­ment of RA ac­counts for $ 9 bil­lion in ex­cess health care costs with di­rect and in­di­rect costs ex­pected to ex­ceed $ 39 bil­lion an­nu­ally.

The re­search team was lead by Sher­ine Gabriel, M. D., M. Sc., and com­pared cur­rent find­ings to prior re­search con­ducted be­tween 1955 and 1994 at the Mayo Clinic. Ex­am­in­ing the med­i­cal records of 1,761 Olm­sted County, Min­nesota res­i­dents 18 years and older who had re­ceived one or more di­ag­noses of arthri­tis of vary­ing types, they found that 466 had a di­ag­no­sis of RA. The mean age of di­ag­no­sis was 55.6 years and 69 per­cent of the RA pa­tients were fe­males.

Al­though a 2.5 per­cent in­crease in the in­ci­dence of RA in women was found, there was a 0.5 per­cent de­crease noted in men. Prior stud­ies have shown that cig­a­rette smok­ing in­creases the risk of RA in both sexes. Cig­a­rette smok­ing has been on the de­cline in the U. S., but the rate is slower in women than men, a fac­tor that might help ex­plain the gen­der dif­fer­ences in RA. Re­searchers also point out that mod­ern oral con­tra­cep­tives have lower doses of es­tro­gens than older med­i­ca­tions. The higher doses of es­tro­gen in the prior con­tra­cep­tives of­fer greater re­sis­tance to RA devel­op­ment. Fi­nally, sev­eral stud­ies have found that Vi­ta­min D de­fi­cien- cies can con­trib­ute to de­vel­op­ing RA and that this de­fi­ciency has in­creased in women over the past decades.

Dr. Ted Mikuls of the Uni­ver­sity of Ne­braska Med­i­cal Cen­ter com­mented in the same is­sue of Arthri­tis and Rheuma­tism that, “ Pub­lic health mea­sures are al­ready un­der way to ad­dress many of the en­vi­ron­men­tal risk fac­tors that have been im­pli­cated in RA risk, in­clud­ing in­ter­ven­tions that en­cour­age smok­ing ces­sa­tion and ef­forts fo­cused at op­ti­miz­ing lev­els of phys­i­cal ac­tiv­ity, vi­ta­min D in­take, and oral hy­giene.” He con­cluded, “ Rea­sons for the in­crease in in­ci­dence we found are un­known, but en­vi­ron­men­tal fac­tors likely play a role and should be fur­ther ex­plored.”

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