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Early menopause, low body mass index, and smoking are independent risk factors for developing giant cell arteritis
  1. K Larsson1,
  2. D Mellström2,
  3. C Nordborg3,
  4. A Odén4,
  5. E Nordborg5
  1. 1Department of Rheumatology, Sahlgrenska University Hospital, Göteborg, Sweden
  2. 2Centre for Bone Research at the Sahlgrenska Academy, Department of Geriatrics, Sahlgrenska University Hospital
  3. 3Department of Pathology, Sahlgrenska University Hospital
  4. 4Department of Pathology, Sahlgrenska University Hospital
  5. 5Department of Rheumatology, Sahlgrenska University Hospital
  1. Correspondence to:
    Dr Claes Nordborg
    Department of Pathology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; claes.nordborg{at}


Objective: To assess female sex hormone related variables in a group of women with biopsy positive giant cell arteritis and a control group.

Methods: 49 women with biopsy positive giant cell arteritis, aged 50 to 69 years at the time of diagnosis, answered a questionnaire on 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 logistic regression analysis of each variable adjusted for age, and a multivariate logistic regression analysis including age and the variables which differed significantly between giant cell arteritis and controls.

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

Conclusions: There was a significant association between hormonal and reproduction related factors and the risk of developing giant cell arteritis in women given the diagnosis before the age of 70. The results suggest a possible role of oestrogen deficiency in the pathogenesis of giant cell arteritis. To confirm the results, an extended study will be needed, including women older than 70.

  • ACTH, adrenocorticotropic hormone
  • BMI, body mass index
  • GCA, giant cell arteritis
  • HLA, human leucocyte antigen
  • HPA, hypothalamic-pituitary-adrenal
  • HPG, hypothalamic-pituitary-gonadal
  • HRT, hormone replacement therapy
  • giant cell arteritis
  • menopause
  • smoking
  • body mass index
  • breast feeding

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  • Published Online First 26 August 2005

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    BMJ Publishing Group Ltd and European League Against Rheumatism