Risk factors in rheumatoid arthritis: analysis of the scientific literature

Abstract

Background. Rheumatoid arthritis is a chronic autoimmune disease with a major impact on patients’ quality of life and functional capacity. Although its exact etiology remains largely unknown, both modifiable and non-modifiable risk factors have been shown to be associated with an increased risk of its development. Objective(s). The aim of the study is to identify and synthesize the risk factors associated with rheumatoid arthritis, using a method based on critical analysis of relevant scientific literature. Materials and methods. 40 peer-reviewed articles published between 2015 and 2024 were selected from the PubMed Central database. The included studies focused on identifying risk factors for rheumatoid arthritis and employed case–control, retrospective cohort, and prospective cohort designs. A narrative, descriptive, and qualitative synthesis of the data was performed. Results. The analysis of the literature demonstrated a consistent association between smoking and elevated risk of rheumatoid arthritis (OR 1.15–3.1; RR 1.10–2.47; HR 9.6). Inhalation of silica dust (OR 1.22–3.5), textile dust (OR 2.5–3.5), and air pollution (OR 1.15– 1.45; HR 1.14) were also identified as contributing factors. High BMI (OR 1.13–1.45), intestinal dysbiosis (e.g., Haemophilus spp., Prevotella copri), and genetic markers (HLADRB1, PTPN22) were significantly linked to the disease. In contrast, the Mediterranean diet, omega-3 fatty acids, fish intake, and vitamin D were associated with a reduced risk (OR 0.57– 0.91; RR 0.65–0.76). Conclusion(s). The analysis confirms the multifactorial etiology of rheumatoid arthritis, showing a complex interaction between genetic predisposition and modifiable risk factors such as smoking, diet, obesity, occupational exposures, and hormonal imbalances influencing disease development.