Favourable lifestyle helps prevent r-axSpA development

Individuals who adhere to a favourable lifestyle have a low risk of developing radiographic axial spondyloarthritis (r-axSpA), according to study.

Overall, 694 patients with r-axSpA were diagnosed over a median follow-up of 13.57 years. Compared with the unfavourable lifestyle, intermediate lifestyle (hazard ratio [HR], 0.67, 95 percent confidence interval [CI], 0.57–0.80) and favourable lifestyle (HR, 0.62, 95 percent CI, 0.49–0.78) correlated with a reduced risk of r-axSpA development.

When considering the combined effect of lifestyle and polygenic risk score (PRS), participants with unfavourable lifestyle and high genetic risk showed the highest risk of developing r-axSpA (HR, 2.18, 95 percent CI, 1.47–3.23) relative to those with favourable lifestyle and low genetic risk. However, there was no evidence suggesting addictive and multiplicative interaction.

In mediation analyses, systemic inflammation partly mediated the inverse relationship between healthy lifestyle score and the risk of developing r-axSpA. This systemic inflammation ranged from 0.20 percent for neutrophil-to-high-density lipoprotein cholesterol ratio to 10.29 percent for C-reactive protein.

“Our study suggested that adherence to a favourable lifestyle significantly reduced the risk of developing r-axSpA by attenuating the systemic inflammatory response, which was independent of genetic susceptibility to r-axSpA,” the investigators said. 

A total of 382,035 individuals without r-axSpA at baseline in the UK Biobank were included in this study. The investigators constructed a combined lifestyle score consisting of six factors and a PRS using r-axSpA–associated genetic loci for each participant. They further classified participants into three categories (unfavourable, intermediate, or favourable lifestyle) based on their score.

The associations of lifestyle and PRS with the risk of r-axSpA development were explored using Cox proportional hazards regression models. In addition, the investigators assessed the association between lifestyle score and r-axSpA mediated by systemic inflammation.