Rheumatoid factor seropositivity is inversely associated with oral contraceptive use in women without rheumatoid arthritis

Department of Preventive Medicine and Biometrics, University of Colorado at Denver and Health Sciences Center, Denver, 4200 East Ninth Avenue, Box B119, Denver, CO 80262, USA.
Annals of the Rheumatic Diseases (Impact Factor: 10.38). 02/2007; 66(2):267-9. DOI: 10.1136/ard.2006.060004
Source: PubMed


To examine whether oral contraceptive use is associated with the presence of serum rheumatoid factor in women of reproductive age without rheumatoid arthritis.
304 women selected from parents of children who were at increased risk of developing type 1 diabetes were studied, because they were enriched with the human leucocyte antigen-DR4 allele, a susceptibility marker for both type 1 diabetes and rheumatoid arthritis. Participants visited a clinic where blood was drawn for rheumatoid factor testing, and exposure data were collected via questionnaires. A medical history and joint examination were performed to rule out rheumatoid arthritis. Participants and examiners were unaware of the participants' rheumatoid factor status at the time of examination and questionnaire.
Use of oral contraceptives at any time was inversely associated with rheumatoid factor positivity (adjusted odds ratio (OR) 0.2, 95% confidence interval (CI) 0.07 to 0.52) independent of age, education and smoking. Smoking > or = 20 pack-years was also associated with rheumatoid factor positivity (adjusted OR 56.38, 95% CI 4.31 to 736.98) compared with never smoking. Smoking 1-19 pack-years was not associated with a positive rheumatoid factor.
Our results suggest that oral contraceptive use, and possibly cigarette smoking, act early in the development of the immune dysregulation that occurs in rheumatoid arthritis.

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Available from: Jill M Norris, Feb 24, 2014
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    • "On the flipside, perhaps it is this subtype's ability to discharge selfish wants and the ensuing guilt, which gives their immune system protection against HPA axis dysregulation and subsequent development of rheumatoid factor [59]. The RF- subtype develops RA along different pathways that are more associated with the DRB1*0301 [78], DRB1*08, DRB1*11, SLC11A1 [79] and HLA-B27 [80] genes, the use of the oral contraceptive pill [81], and increased IL-1ss and IL-12p40 cytokines leading to a monocyte-based inflammatory cascade [82]. The RF- subtype is not associated to socioeconomic status. "
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