0f6c198f-8a63-476f-9377-1660e6735e58.json

{
 "id": "0f6c198f-8a63-476f-9377-1660e6735e58",
 "disease": {
  "id": "H00630",
  "names": [
   "Rheumatoid arthritis"
  ],
  "dbLinks": {
   "icd10": [
    "M05"
   ],
   "mesh": [
    "D001172"
   ]
  },
  "category": "Immune system disease",
  "description": "Rheumatoid arthritis (RA) is a common autoimmune disease that primarily manifests as chronic inflammatory arthropathy. Persistent synovitis leads to cartilage destruction, bone erosions and periarticular decalcification, subsequently resulting in impaired joint function. It is more common between the ages of 35 and 50 years, affecting three times more women than men. Susceptibility to RA is genetically determined with multiple genes contributing. Inheritance of HLA DRB1 alleles encoding a distinctive five-amino-acid sequence known as the \"shared epitope\" (SE) is the best characterized genetic risk factor. The mechanism by which the SE alleles contribute to the development of RA is not very clear. It has been postulated that the presence of these conserved sequences in the antigen-binding groove alters the way antigenic peptides are bound to and presented to T-cell lymphocytes. This, in turn, may trigger abnormal immune responses and lead to RA."
 },
 "article": {
  "id": "25926142",
  "text": "OBJECTIVES:\nTo assess whether HOUSES (HOUsing-based index of socioeconomic status (SES)) is associated with risk of and mortality after rheumatoid arthritis (RA).\n\nDESIGN:\nWe conducted a population-based case-control study which enrolled population-based RA cases and their controls without RA.\n\nSETTING:\nThe study was performed in Olmsted County, Minnesota.\n\nPARTICIPANTS:\nStudy participants were all residents of Olmsted County, Minnesota, with RA identified using the 1987 American College of Rheumatology criteria for RA from 1 January 1988, to 31 December 2007, using the auspices of the Rochester Epidemiology Project. For each patient with RA, one control was randomly selected from Olmsted County residents of similar age and gender without RA.\n\nPRIMARY AND SECONDARY OUTCOME MEASURE:\nThe disease status was RA cases and their matched controls in relation to HOUSES as an exposure. As a secondary aim, post-RA mortality among only RA cases was an outcome event. The associations of SES measured by HOUSES with the study outcomes were assessed using logistic regression and Cox models. HOUSES, as a composite index, was formulated based on a summed z-score for housing value, square footage and number of bedrooms and bathrooms.\n\nRESULTS:\nOf the eligible 604 participants, 418 (69%) were female; the mean age was 56±15.6 years. Lower SES, as measured by HOUSES, was associated with the risk of developing RA (0.5±3.8 for controls vs -0.2±3.1 for RA cases, p=0.003), adjusting for age, gender, calendar year of RA index date, smoking status and BMI. The lowest quartile of HOUSES was significantly associated with increased post-RA mortality compared to higher quartiles of HOUSES (HR 1.74; 95% CI 1.10 to 2.74; p=0.017) in multivariate analysis.\n\nCONCLUSIONS:\nLower SES, as measured by HOUSES, is associated with increased risk of RA and mortality after RA. HOUSES may be a useful tool for health disparities research concerning rheumatological outcomes when conventional SES measures are unavailable."
 },
 "questions": [
  {
   "id": "33148eba-29a3-402d-807a-674e0c3f01d7",
   "text": "What are the risk factors of Rheumatoid arthritis?",
   "answers": [
    {
     "answer_start": 1335,
     "text": "Lower SES, as measured by HOUSES"
    },
    {
     "answer_start": 61,
     "text": "socioeconomic status (SES))"
    },
    {
     "answer_start": 1767,
     "text": "Lower SES, as measured by HOUSES"
    }
   ]
  }
 ]
}