ArticleRheumatology (Oxford, England)2022
The impact of education inequality on rheumatoid arthritis risk is mediated by smoking and body mass index: Mendelian randomization study.
Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Causal risk and protective factors for rheumatoid arthritis: a comprehensive mendelian randomization systematic review and meta-analysis.Frontiers in genetics · 2026Pooled it
- Pooled it
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- Genetic Association of Sexual Behavior, Sildenafil, and Hormonal Contraceptives With Mental Disorders.CNS neuroscience & therapeutics · 2026Article
- Smoking as a determinant of rheumatoid arthritis: integrated evidence from epidemiological patterns, genetic signals, and mechanistic insights.Archives of medical science : AMS · 2026Article
- Association Between Educational Attainment and the Risk of Gynecological Malignancies: A Mediation Mendelian Randomization Study.International journal of women's health · 2026Article
- Article
- Causal relationship between physical activity, sleep duration, sedentary behavior, and hypertension: A Mendelian randomisation study.American journal of preventive cardiology · 2025Article
- The impact of educational attainment on gestational diabetes mellitus is mediated by body mass index: A Mendelian randomization study.Medicine · 2025Article
- The association between social determinants of health and all-cause, cardiovascular mortality in US rheumatoid arthritis: a cohort study of NHANES.BMC public health · 2025Article
- Efficient and scalable construction of clinical variable networks for complex diseases with RAMEN.Cell reports methods · 2025Article
- Assessing the Causal Association Between COVID-19 and Graves Disease: Mendelian Randomization Study.JMIR formative research · 2025Article
- Associations between life's essential 8 and arthritis among adults in United States: a national-wide longitudinal study.BMC public health · 2025Article
- Trends in Anxiety and Depression Among Individuals With Rheumatoid Arthritis: A Population-Based Study.The Journal of rheumatology · 2025Article
- Causal Mediation Analysis: A Summary-Data Mendelian Randomization Approach.Statistics in medicine · 2025Article
- Causal relationship between type II diabetes mellitus, metformin, insulin, gliclazide, and esophageal cancer-insights from two-sample Mendelian randomization study and meta-analysis.Journal of thoracic disease · 2025Article
- What Is the Real Impact of Smoking on Diseases Alleged to Benefit from It?European addiction research · 2025Review
- Association and mediation between circulating inflammatory proteins and skin fibrosis.Frontiers in endocrinology · 2025Article
- Chinese guidelines for the diagnosis and treatment of rheumatoid arthritis: 2024 update.Rheumatology and immunology research · 2024Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo estimate the causal relationship between educational attainment-as a proxy for socioeconomic inequality-and risk of RA, and quantify the roles of smoking and BMI as potential mediators.
methodsUsing the largest genome-wide association studies (GWAS), we performed a two-sample Mendelian randomization (MR) study of genetically predicted educational attainment (instrumented using 1265 variants from 766 345 individuals) and RA (14 361 cases, 43 923 controls). We used two-step MR to quantify the proportion of education's effect on RA mediated by smoking exposure (as a composite index capturing duration, heaviness and cessation, using 124 variants from 462 690 individuals) and BMI (517 variants, 681 275 individuals), and multivariable MR to estimate proportion mediated by both factors combined.
resultsEach s.d. increase in educational attainment (4.2 years of schooling) was protective of RA (odds ratio 0.37; 95% CI: 0.31, 0.44). Higher educational attainment was also protective for smoking exposure (β = -0.25 s.d.; 95% CI: -0.26, -0.23) and BMI [β = -0.27 s.d. (∼1.3 kg/m2); 95% CI: -0.31, -0.24]. Smoking mediated 24% (95% CI: 13%, 35%) and BMI 17% (95% CI: 11%, 23%) of the total effect of education on RA. Combined, the two risk factors explained 47% (95% CI: 11%, 82%) of the total effect.
conclusionHigher educational attainment has a protective effect on RA risk. Interventions to reduce smoking and excess adiposity at a population level may reduce this risk, but a large proportion of education's effect on RA remains unexplained. Further research into other risk factors that act as potentially modifiable mediators are required.
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