Objective: Several studies have suggested that alcohol drinking is protective for the development and progression of systemic lupus erythematosus (SLE). However, a protopathic bias might also explain this apparent association. Our objective was to investigate the association between alcohol consumption and incidence of SLE in a dataset that has information on both current and pre-diagnostic alcohol consumption.
Methods: We performed an Internet-based case-control study of SLE. Cases were diagnosed within 5 years of the study and met > 4 ACR criteria for SLE. The control participants were tightly matched to cases on demographic and socioeconomic characteristics using a propensity score. Participants completed an online exposure assessment. We used conditional logistic regression analyses to test the association of current and pre-diagnostic alcohol consumption with SLE.
Results: The sample comprised 114 cases with SLE and 228 matched controls. Current drinking (>2 days per week) was inversely associated with SLE (OR, 0.35, 95% CI, 0.13-0.98). Having more than 2 drinks per day was also inversely associated with SLE (OR, 0.41, 95% CI, 0.18-0.93). However, alcohol consumption before SLE diagnosis was not associated with the risk of SLE (p>=0.4). Analysis of the change in drinking habits showed that people with lupus were more likely to quit drinking before (OR, 2.25, 95% CI, 0.96-5.28) or after (OR, 2.38, 95% CI, 0.88-6.49) being given the SLE diagnosis.
Conclusions: Our results show that alcohol consumption before SLE diagnosis is not associated with the risk for SLE, and that individuals who develop SLE are more likely to quit.
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