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Influence of alcohol consumption on the risk of systemic lupus erythematosus among women in the Nurses’ Health Studies

A study published in the journal Arthritis Care and Research assessed the association between alcohol consumption and risk of systemic lupus erythematosus (SLE) among women followed in the Nurses’ Health Study (NHS) and NHSII. They hypothesised that alcohol consumption, possibly through anti-inflammatory effects, would be associated with lower risk for SLE compared to no alcohol consumption.

The NHS enrolled 121,701 US female registered nurses in 1976. NHS II began in 1989, enrolling 116,430 female nurses. Lifestyle and environmental exposures were collected through biennial questionnaires. Alcohol consumption was assessed with questionnaire completed every 4 years. Participants in NHS and NHSII who provided alcohol data at baseline (1980 in NHS and 1989 in NHSII) were included. Cumulative average alcohol consumption until 2-4 years prior to SLE diagnosis date (for cases) across repeated measures was to best represent longterm alcohol consumption. The incident SLE cases were identified using the connective tissue disease screening questionnaire, followed by medical record review. Cox proportional hazards models were used to assess associations.

118 incident SLE cases developed in NHS from 1980- 2008, and 92 incident SLE cases developed in NHSII, 1991-2009. Mean age at diagnosis was 53.6 (± 8.2) years in NHS and 43.4 (± 5.7) in NHSII.

Most SLE cases (97% in NHS, 100% in NHSII) were ANA positive, while 33% of NHS SLE cases and 53% of those in NHSII had a positive anti-dsDNA antibody test at diagnosis. In both NHS and NHSII, there was a suggestion of a protective effect of alcohol intake on risk of SLE, although it was not statistically significant Meta-analysis of the multivariable-adjusted results from both cohorts demonstrated a suggested protective effect of alcohol consumption in women who consume >0 to 10 gms/day (HR 0.75, 95%CI 0.54, 1.04) and >10 gms/day (HR 0.61,95% CI 0.37, 1.01).

In these large prospective cohorts of women followed for many years before the diagnosis of SLE, the study found a potential protective association between long-term alcohol consumption and reduced risk of developing SLE. Further studies are needed to confirm these findings, the researchers suggest.

Source: Influence of Alcohol Consumption on the Risk of SLE Among Women in the Nurses’ Health Studies. M Barbhaiya, B Lu, S-C Chang, JA Sparks, EW Karlson and KH. Costenbader. Arthritis Care & Research, online DOI: 10.1002/acr.22945.

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