Decline of Lung Function Is Associated with the Presence of Rheumatoid Factor in Korean Health Screening Subjects without Clinically Apparent Lung Diseases

Jiwon Hwang¹, Jae-Uk Song², Hyungjin Kim³, Hyemin Jeong⁴, Yeong Hee Eun⁵, Chan Hong Jeon⁶, Ji-Min Oh⁷, Jaejoon Lee⁴, Hoon-Suk Cha⁸, Eun-Mi Koh⁵ and Joong Kyong Ahn⁹, ¹Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, ²Department of Internal Medicine, Kangbuk Samsung Hospital, Seoul, South Korea, ³Department of medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁴Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁵Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁶Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, South Korea, ⁷Anyang SAM Hospital, Anyang, South Korea, ⁸Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, ⁹Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Rheumatoid Factor

Session Information

Date: Tuesday, November 10, 2015

Title: Epidemiology and Public Health Poster III (ACR): Gout and Non-Inflammatory Musculoskeletal Conditions

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Rheumatoid factor (RF) is an autoantibody directed against the Fc component of IgG. It is present in approximately 70-80% of rheumatoid arthritis (RA) patients but also found nonspecifically in chronic inflammatory condition such as sarcoidosis, hepatitis B or C infection, and tuberculosis. It has been suggested that lung may be an important sites generating or sequestering autoantibodies by immune dysregulation. Also, RF-positive patients without inflammatory arthritis showed significantly higher frequency of inflammatory airway abnormality. However, little is known about the influence of RF on pulmonary function in health screening subjects without any specific medical problem. This study aimed to determine the effect of the presence of RF on pulmonary function in Korean health screening subjects without any history of joint disease and clinically apparent lung diseases.

Methods: Of the 114,944 people who participated in a health checkup program in 2010, 94,438 subjects with normal chest radiography were recruited, whose results of RF and pulmonary function test (PFT) using spirometry were available. Subjects with arthralgia or the past medical history of arthritis including RA, and lung diseases were excluded based on self-reported questionnaire. Association between RF and PFT was assessed by correlation analysis.

Results: Among 94,438 people, RF was positive in 3,326 subjects (3.52%). Their mean age was 41.3 ± 8.3 (range, 21 – 83) and 43.8% were female; these characteristics were not significantly different from those of RF-negative subjects. Ever-smokers (ex- and current smokers) were 39% in RF-positive subjects while 41.2% in RF-negative subjects (p = 0.009). Hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibodies (anti-HCV) were more frequently seen in RF-positive subjects (12.1% vs. 3.5%, p < 0.001 for HBsAg and 0.5% vs. 0.1%, p < 0.001 for anti-HCV). Regarding PFT, RF-positive subjects had lower forced vital capacity (FVC) and forced expiratory volume in on second (FEV₁) compared to RF-negative subjects (3.79 ± 0.83 L vs. 3.87 ± 0.83 L, p < 0.001 and 3.17 ± 0.66 vs. 3.25 ± 0.67 L, p < 0.001). The proportion of subjects with FVC below 82% and FEV₁ below 84% of the predicted value was significantly higher in RF-positive subjects (50.7% vs. 46.6%, p < 0.001 and 54.5% vs.49.4%, p < 0.001) but the frequency of airflow limitation (FEV₁/FVC ≤ 70%) did not differ between two groups (1.4% vs. 1.5%, p = 0.47). FVC and FEV₁ had negative correlations with the RF titers (r = -0.053, p < 0.001 in FVC and r = -0.055, p < 0.001 in FEV₁). Multivariate logistic regression analysis showed that RF positivity was an independent predictor for the reduction of FVC (adjusted OR = 1.10, 95% CI 1.01 – 1.20, p < 0.001) and FEV1 (adjusted OR = 1.18, 95% CI 1.08 – 1.28, p < 0.001).

Conclusion: The results suggest that the presence of RF could impact on pulmonary function in healthy subjects without clinically apparent lung diseases. A follow up study for the serial changes of PFT may reflect the actual influence of the raised RF titers.

Disclosure: J. Hwang, None; J. U. Song, None; H. Kim, None; H. Jeong, None; Y. H. Eun, None; C. H. Jeon, None; J. M. Oh, None; J. Lee, None; H. S. Cha, None; E. M. Koh, None; J. K. Ahn, None.

To cite this abstract in AMA style:

Hwang J, Song JU, Kim H, Jeong H, Eun YH, Jeon CH, Oh JM, Lee J, Cha HS, Koh EM, Ahn JK. Decline of Lung Function Is Associated with the Presence of Rheumatoid Factor in Korean Health Screening Subjects without Clinically Apparent Lung Diseases [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/decline-of-lung-function-is-associated-with-the-presence-of-rheumatoid-factor-in-korean-health-screening-subjects-without-clinically-apparent-lung-diseases/. Accessed .

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