Sleep patterns, physical activity, genetic susceptibility, and incident rheumatoid arthritis: a prospective cohort study

作者：Jing Ni, Qiang Zhou, Shi-Ying Meng, Ting-Dong Zhou, Tian Tian, Hai‐Feng Pan · 发表于：BMC Medicine · 年份：2024 · DOI：10.1186/s12916-024-03615-5 · 被引用次数：25 · 研究领域：Rheumatoid Arthritis Research and Therapies、Sleep and related disorders、Spondyloarthritis Studies and Treatments

Sleep and physical activity (PA) are thought to be interconnected with the development of rheumatoid arthritis (RA). However, the precise nature and extent of these relationships have yet to be fully quantified. This study aimed to quantify the longitudinal effects of sleep behaviors, PA, and genetic susceptibility on the incidence of RA and to estimate the combined effects and interactions among these exposures. A total of 363,211 adults were derived from a large European cohort. We incorporated five sleep behaviors (sleep duration, insomnia, snoring, chronotype, and daytime sleepiness) to generate sleep patterns, which were defined based on healthy sleep scores. Multivariate-adjusted Cox proportional hazard models were conducted to assess the individual and combined associations of sleep patterns, PA, and genetic susceptibility with the risk of RA occurrence. Multiplicative and additive interactions were estimated by P interaction and relative excess risk due to interaction (RERI) between each of the two exposures. During a follow-up of 12.5 years, 4262 RA cases were ascertained. A healthy sleep pattern was associated with a decreased risk of RA in a dose-response manner, with an adjusted hazard ratio (HR) of 0.79 (95% confidence interval [CI] = 0.75–0.84), independent of traditional risk factors and genetic predisposition. Under the restricted cubic splines model, a non-linear association was detected for PA and RA risk. Participants in the intermediate quintile 3 showed t...