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Table 5 Hazard ratios for rheumatoid arthritis phenotypes according to quartiles of marine omega-3 polyunsaturated fatty acida intake in the Nurses’ Health Study and Nurses’ Health Study II (n = 166,013)

From: Association of fish intake and smoking with risk of rheumatoid arthritis and age of onset: a prospective cohort study

  Marine omega-3 polyunsaturated fatty acid intakea
Quartile 1 Quartile 2 Quartile 3 Quartile 4 p for trend
HR (95%CI) HR (95%CI) HR (95%CI) HR (95%CI)
All RA
 Cases/person-years 251/945,683 269/969,619 279/980,365 281/968,243  
 Age-adjusted modelb 1.00 (Ref) 1.03 (0.87–1.22) 1.05 (0.88–1.24) 1.04 (0.88–1.24) 0.65
 Multivariable modelc 1.00 (Ref) 1.05 (0.88–1.25) 1.09 (0.91–1.31) 1.12 (0.91–1.37) 0.28
Seropositive RA
 Cases/person-years 167/943,993 153/967,552 177/978,198 175/966,331  
 Age-adjusted modelb 1.00 (Ref) 0.88 (0.70–1.09) 1.00 (0.81–1.23) 0.97 (0.79–1.21) 0.82
 Multivariable modelc 1.00 (Ref) 0.92 (0.73–1.15) 1.08 (0.86–1.36) 1.12 (0.87–1.43) 0.19
Seronegative RA
 Cases/person-years 84/943,360 116/967,367 102/977,670 106/965,464  
 Age-adjusted modelb 1.00 (Ref) 1.34 (1.01–1.77) 1.14 (0.86–1.53) 1.18 (0.89–1.58) 0.64
 Multivariable modelc 1.00 (Ref) 1.31 (0.98–1.75) 1.12 (0.82–1.51) 1.14 (0.81–1.59) 0.92
All RA among ≤ 55 years
 Cases/person-years 125/565,147 139/564,890 120/548,635 107/513,366  
 Age-adjusted modelb 1.00 (Ref) 1.10 (0.87–1.41) 0.96 (0.75–1.24) 0.90 (0.69–1.17) 0.23
 Multivariable modelc 1.00 (Ref) 1.10 (0.86–1.41) 0.98 (0.75–1.27) 0.93 (0.69–1.25) 0.40
All RA among > 55 years
 Cases/person-years 126/386,863 130/411,627 159/438,231 174/461,250  
 Age-adjusted modelb 1.00 (Ref) 0.96 (0.75–1.23) 1.12 (0.89–1.42) 1.16 (0.92–1.47) 0.097
 Multivariable modelc 1.00 (Ref) 1.00 (0.77–1.28) 1.20 (0.93–1.54) 1.29 (0.98–1.69) 0.031
  1. aDietary and supplementary intake of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA) were considered as marine omega-3 polyunsaturated fatty acids
  2. bAdjusted for age, questionnaire period, cohort, and total energy intake (continuous)
  3. cMultivariable models were adjusted for age, questionnaire period, cohort, total energy intake (continuous), median household income (quartiles), cigarette smoking (never, past 1–14/day, past ≥14/day, current 1–14/day, current ≥14/day), body mass index category (underweight/normal, overweight, obese), alcohol intake (never to < 5, 5 to < 10, ≥10 g/day), alpha-linolenic acid (g/d), trans fatty acids (g/d), saturated fatty acids (g/d), monounsaturated fatty acids (g/d), omega-6 polyunsaturated fatty acids (g/d), and protein (g/d)
  4. CI confidence interval, HR hazard ratio, RA rheumatoid arthritis