Moderate Alcohol Consumption May be Associated With Reduced Lupus Risk in Women
SLE risk factors such as oral contraceptive pill use and smoking did not modify the inverse association between reduced SLE risk and moderate alcohol consumption.
Women who consume a moderate amount of alcohol daily had a reduced risk of developing systemic lupus erythematosus (SLE) compared with women who did not consume alcohol at all, according to recent research of 2 groups of nurses published in Arthritis Care & Research.1
"In these 2 large, prospective cohorts of women followed for many years prior to the onset of SLE, we found a robust inverse association between alcohol consumption and SLE risk," Medha Barbhaiya, MD, MPH, from the Department of Medicine, Division of Rheumatology and Immunology and Allergy at Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, and colleagues wrote.
The investigators evaluated 2 groups totaling 204,055 women from the Nurses' Health Study (NHS) and NHSII cohorts who had information about alcohol consumption available at baseline, which consisted of registered nurses who were greater than 90% white and free of connective tissue disease. Women in the NHS cohort (1980-2012) were between the ages 30 and 55 years in 11 different states (n=121,700), whereas women in the NHSII cohort (1989-2011) were between the ages of 25 in 42 years in 14 different states (n = 116,670).
The researchers found 125 cases of SLE in the NHS cohort (mean age of diagnosis, 55.8±9.5 years) and 119 SLE cases in the NHSII group (mean age of diagnosis, 43.4±7.7 years). When evaluating alcohol consumption, Dr Barbhaiya and colleagues performed a meta-analysis of multivariate hazard ratios (HRs) and found an inverse association between moderate alcohol consumption of ≥5 g/day and SLE (HR, 0.61; 95% CI, 0.41-0.89; P <.01 for trend). Among women who drank more than 2 glasses of wine per day, the most common type of alcohol consumed, there was a significant decrease in SLE risk (HR, 0.65; 95% CI, 0.45-0.96; P <.03 for trend) compared with women who drank no wine.
Dr Barbhaiya and colleagues said SLE risk factors such as oral contraceptive pill use and smoking did not modify the inverse association between reduced SLE risk and moderate alcohol consumption in their analysis. Among women in the NHSII group, there was no significant change in alcohol intake between 1991 and 2003, indicating similar results in short-term long-term, baseline, and lagged-alcohol analyses.
Summary and Clinical Applicability
"[T]he potential benefits of moderate alcohol consumption among premenopausal and postmenopausal women have to be weighed against the other possible health risks, with cancer risk (especially breast cancer) being a major concern even for light to moderate alcohol consumption," the investigators wrote in their study. "Our findings have implications for SLE prevention in that identifying risk factors, and those associated with decreased risk, enables risk factor modification and provides insight into disease pathogenesis."
- Study used what researchers called a "strict SLE definition," which may have excluded possible SLE cases that were later confirmed.
- Self-reported questionnaires can potentially misclassify alcohol and lack differentiation of different types of alcohol for SLE association.
- Lack of generalizability from the mostly healthy, white US female cohort of nurses to other populations and people with other socioeconomic statuses.
- Barbhaiya M, Lu B, Sparks JA, et al. Influence of alcohol consumption on the risk of systemic lupus erythematosus among women in the Nurses' Health Study cohorts. Arthritis Care Res. 2017;69(3):384-392. doi: 10.1002/acr.22945