Are You At Risk Of Rheumatoid Arthritis? Know Your Risk

What is Rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disorder in which the body's immune system (which normally protects us attacking foreign substances like bacteria and viruses) mistakenly attacks the joints. This creates inflammation that causes the tissue that lines the inside of joints (the synovium) to thicken, which further results in swelling and pain in and around the joints. The synovium makes a fluid that lubricates the joints and helps them move smoothly. If inflammation is not treated on time, it can damage the cartilage, the elastic tissue that covers the ends of bones in a joint, as well as the bones themselves. Over a period of time this could lead to loss of cartilage, and the spacing between joints and bones can become smaller. Joints can become loose, unstable, painful and may even lose their mobility. There is a possibility that joint deformity occurs. Joint damage cannot be reversed; however, doctors recommend early diagnosis and treatment to control this arthritis.

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What are some common factors of Rheumatoid arthritis?

Common factors likely to increase the risk of rheumatoid arthritis can be categorized into non-modifiable and modifiable. These include:

1. Gender: Rheumatoid arthritis afflicts women more often than men. Out of every four persons with rheumatoid arthritis, three are women.

2. Age: Rheumatoid arthritis can occur at any age, peak incidence being at 40 years.

3. Family history: A family member suffering from rheumatoid arthritis confers a higher risk of the disease because of the genetic predisposition. The incidence of disease among first degree family members is 0.8%, when compared to 0.5% in the general population.

4. Smoking: Cigarette smoking increases the risk of developing the disease. A smoker with certain genetic make-up has a 40-fold chance of developing RA, indicating the interaction between genetic and environmental risk factors in the development of RA. There is also a long latency (up to 20 years) after cessation of smoking to return to the risk level of a non-smoker.

5. Environmental factors: Exposures to asbestos or silica, bacterial or viral infection may increase the risk for developing rheumatoid arthritis.

6. Periodontitis: Periodontitis is a chronic inflammatory disease of the gingiva and is a risk factor for development of rheumatoid arthritis.

7. Dietary risk factors: Red meat intake and vitamin D deficiency increase the risk of RA. Excessive coffee consumption and high salt intake are also risk factors. On the other hand, fish oil (due to its omega-3 fatty acids), antioxidants in fruits and vegetables (vitamin C, vitamin E, carotenoids, and lycopene) have a protective effect against RA.

8. Hormonal factors: Nulliparity increases RA risk while pregnancy ameliorates RA in majority of women.

9. Obesity: People who are obese appear to be at a higher risk of developing rheumatoid arthritis. 

Gender, age and genetic background are non-modifiable risk factors for rheumatoid arthritis.

Also read: Can Running Lead To Osteoarthritis?

Smoking increases the risk of developing the disease. A smoker with certain genetic make-up has a 40-fold chance of developing RA, indicating the interaction between genetic and environmental risk factors in the development of RA. There is also a long latency (up to 20 years) after cessation of smoking to return to the risk level of a non-smoker."

Dr. Ashit Syngle

Senior Consultant Physician & Rheumatologist Fortis, Mohali

What are the causes of rheumatoid arthritis?

RA is an autoimmune disease. The genetic and environmental factors interact to initiate and propagate the autoimmune process, resulting in tissue inflammation and injury. The inflammatory cytokines produced in the joints incite joint pain and swelling initially, which if left unchecked can lead to irreversible joint damage and loss of function. The cytokines through the blood stream reach distant organs resulting in systemic features of the disease.

What are the preventive measures for rheumatoid arthritis?

RA can be potentially prevented by modifying environmental factors especially in high risk population - first degree relatives of RA patients, twins of RA patients, autoantibody-positive individuals, population with high disease prevalence rate. Early diagnosis and early treatment can lead to effective disease control and limit joint destruction and prevent various complications of the disease like joint deformity and loss of function, osteoporosis, cardiovascular morbidity and mortality.

Also read: 7 Foods That Trigger Arthritis

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