Parental history of lupus and rheumatoid arthritis and risk in offspring in a nationwide cohort study: does sex matter?
- 1Department of Internal Medicine, Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
- 2Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
- 3Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé, Denmark
- Correspondence to Emily C Somers, University of Michigan, Division of Rheumatology, 24 Frank Lloyd Wright Drive, PO Box 481, Ann Arbor, Michigan 48109-5358, USA;
- Accepted 9 April 2012
- Published Online First 14 May 2012
Objectives To examine the familial risk of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), including juvenile rheumatoid/idiopathic arthritis (JRA), in a population-based setting; and to determine whether patterns of transmission differ according to the sex of the parent or offspring, in order to provide insight into the potential impact of X-chromosomal factors on sex disparities in these autoimmune diseases.
Methods A population-based cohort of parent–offspring triads from Denmark (1977–2010) was established. SLE and RA incidence rates among offspring were calculated, and Cox regression was performed to assess the sex-specific risk of disease in offspring according to maternal or paternal disease history.
Results Among 3 513 817 parent–offspring triads, there were 1258 SLE cases among offspring (1095 female, 163 male) and 9118 cases of RA/JRA (6086 female, 3032 male). Among female offspring, SLE risk was nearly the same according to maternal (HR 14.1) or paternal (HR 14.5) history (p=NS); likewise among male offspring, risk according to maternal (HR 5.5) and paternal (no cases) history were similar (p=NS). For RA, all risk estimates were similar, regardless of the sex of the offspring or parent (HR 2.6–2.9; p=NS).
Conclusions The authors quantified the familial risk of SLE and RA in a nationwide cohort study. For both diseases, transmission was comparable among both female and male offspring of maternal and paternal cases. These data provide evidence at the population level that X-chromosomal factors do not play a major role in sex disparities associated with the risk of SLE and RA.
Competing interests None.
Funding This study was supported by an Arthritis Foundation new investigator award and an Elizabeth C Crosby research award (both to ECS) and by the Aarhus University Clinical Research Foundation.
Provenance and peer review Not commissioned; externally peer reviewed.