Early menopause, low body mass index and smoking are independent risk factors for developing giant cell arteritis

Karolina Larsson ¹, Dan Mellström ², Claes Nordborg ^3*, Anders Odén ³ and Elisabeth Nordborg ¹

¹ Rheumatology, Sweden
² Geriatrics, Sweden
³ Laboratory medicine, Sweden

^* To whom correspondence should be addressed. E-mail: claes.nordborg{at}vgregion.se.

Accepted 22 August 2005

Abstract

Objectives: To assess a number of female sex hormone-related items in a group of women with biopsy- positive giant cell arteritis (GCA) and in a control group.

Methods: Women with biopsy-positive GCA, aged 50- 69 at the time of diagnosis, answered a questionnaire regarding hormonal and reproductive factors. The same questions were answered by a large population of women from the same geographical area, in connection with routine mammograms. The results were tested statistically, using a) logistic regression analysis of each variable adjusted for age and b) a multivariate logistic regression analysis including age and the variables which differed significantly between GCA and controls.

Results: According to the multivariate logistic regression analysis, three independent variables, were associated with an increased risk of having GCA; smoker and ex-smoker: odds ratio (OR) = 6.324; 95% confidence interval (CI) = 3.503 - 11.418; p<0.0001; BMI (body mass index): a reduction of 1.0 kg/m2 increased the risk 10%: OR = 0.898; CI = 0.846 - 0.952; p = 0.0003; menopause before the age of 43: OR = 3.521; CI = 1.717 - 7.220; p = 0.0006.

Conclusion: This study shows a statistically significant association between hormonal and reproduction-related factors and the risk of developing GCA in women given the diagnosis before the age of 70. The results may indicate a possible role of estrogen deficiency in the pathogenesis of GCA. To confirm the results, an extended study will be needed, including women older than 70.

Keywords: BMI, breast feeding, giant cell arteritis, menopause, smoking

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