Page last updated: August 16, 2013
Early arthritis associated with reduced consumption of alcohol

Patients who have early arthritis consume less alcohol than controls, regardless of the type of arthritis, according to a new study published online in the journal Rheumatology. In rheumatoid arthritis (RA) specifically, the inverse association between alcohol and disease was found to be greater in men than it was in women.

Studies examining alcohol consumption and RA have so far had conflicting results. In this new study, Annekoos L. Huidekoper, Diane van der Woude, and colleagues investigated whether there is an association between alcohol consumption and arthritis in general, and with RA in particular.

992 patients who had had arthritis and different diagnoses including RA, osteoarthritis, reactive arthritis, spondylarthritis, and psoriatic arthritis for two years or less, as well as 5,868 controls, were asked about their alcohol consumption. Those interviewed by a nurse were asked for an exact number of alcoholic drinks consumed per week, while those who filled in the questionnaire were asked whether they consumed alcohol, and if they did, how many units per week.

The research identified a inverse relationship between drinking alcohol and the presence of all forms of arthritis. While 83% of the controls reported drinking alcohol, 53-68% of arthritis patients reported consuming alcohol. The lowest figure came from respondents with ACPA-positive RA, while the highest figure came from patients with psoriatic arthritis. In patients with RA, the inverse association between alcohol and the disease was greater in men than it was in women, although this difference was not seen in the patients with other types of arthritis. However, the study did not find any significant dose-response relationship, nor did they detect an association between alcohol and the rate of joint destruction when examined over seven years.

Diane van der Woude, one of the lead authors of the study, commented: “Our findings can be interpreted in several ways. One hypothesis might be that alcohol may suppress both the innate and adaptive immune system leading to a decrease of joint inflammation, as has been suggested by some previous studies.

“Another possible explanation for our findings is that people with arthritis drink less alcohol due to their illness. This explanation seems probable since we observed a relationship between alcohol and the level of inflammation.”

While the study does have limitations, such as the risk of interviewer bias and recall bias, it is, to the authors’ knowledge, the first to include not just patients with RA, but also patients with other types of arthritis, and the finding that alcohol is also inversely associated with these other types of the disease sheds new light on the association between alcohol consumption and RA. It also questions whether the effect of alcohol on the underlying pathophysiology is specific to RA.

Source: ‘Patients with early arthritis consume less alcohol than controls, regardless of the type of arthritis’ by Annekoos L. Huidekoper et al., Rheumatology, DOI: 10.1093/rheumatology/ket212.

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