Effects Of Smoking On Autoantibodies And Disease Activity In Patients With Rheumatoid Arthritis

Objective To compare the levels of anti-CCP antibodies,RF and disease activity indicators of patients with rheumatoid arthritis of smoking,passive smoking,and no-smoking,explore the impact of smoking and passive smoking on patients with rheumatoid arthritis,and provide guidance for patients' life-style to help better control disease activity and improve long-term prognosis.Methods A total of 222 patients with RA who were treated in the inpatient department of the Minda Hospital of Hubei Minzu University from November 2018 to October 2019 were collected,including 82 cases of initial treatment and 140 cases of retreatment.A questionnaire containing basic information,smoking and passive smoking information has been completed.The number of joint swelling and joint tenderness,anti-CCP antibodies,RF,ESR,and CRP in patients with RA were recorded.Disease activity scores are calculated,such as DAS28,SDAI,CDAI scores.Serum samples were collected and tested for TNF? concentration.The effects of smoking and passive smoking on various indicators of patients with RA were analyzed.Results 1.Among newly diagnosed patients with RA,anti-CCP antibodies and RF levels of smokers were higher than those of non-smokers(P = 0.030,P = 0.000),and anti-CCP antibodies and RF levels of passive smokers were higher than those of non-smokers(P = 0.047,P = 0.008).There was no significant difference in anti-CCP antibody and RF levels between smokers and passive smokers.No such differences were observed in treated patients.2.Among newly diagnosed patients with RA,the ESR and CRP levels of smokers were higher than those of non-smokers(P = 0.037,P = 0.010).There was no significant difference in ESR and CRP levels between passive smokers and non-smokers.The ESR and CRP levels of smokers were higher than those of passive smokers(P = 0.015,P = 0.001).No such differences were observed in treated patients.3.In newly treated patients with RA,smokers' DAS28,SDAI,and CDAI scores were higher than those of non-smokers(P = 0.000,P = 0.004,P = 0.011),CDAI of passive smokers were higher than those of non-smokers(P = 0.037),and SDAI scores of smokers higher than passive smokers(P = 0.003).Among retreated patients with RA,smokers had higher DAS28,SDAI,and CDAI scores than nonsmokers(P = 0.000,P = 0.045,P = 0.001),passive smokers had higher DAS28 and CDAI than nonsmokers(P = 0.005,P = 0.013),the SDAI of smokers was higher than passive smokers(P = 0.012).4.There was no significant difference in TNF ?concentration between smokers,passive smokers,and non-smokers in patients,regardless of whether they are newly treated or retreated.(P=0.108,P =0.126).Conclusion 1.Smoking and passive smoking both increased the anti-CCP antibodies and RF levels.2.Smoking increased the ESR and CRP of patients with RA,and passive smoking didn't increase the ESR and CRP levels of patients with RA.3.Smoking increased the disease activity scores of patients with RA,which contains DAS28,SDAI,CDAI scores,and passive smoking has less effect on disease activity scores.