{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:22:41Z","timestamp":1790468561402,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,21]],"date-time":"2017-09-21T00:00:00Z","timestamp":1505952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AR\u2010049880"],"award-info":[{"award-number":["AR\u2010049880"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AR\u2010052403"],"award-info":[{"award-number":["AR\u2010052403"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AR\u2010059073"],"award-info":[{"award-number":["AR\u2010059073"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["AR\u2010066109"],"award-info":[{"award-number":["AR\u2010066109"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA\u2010186107"],"award-info":[{"award-number":["CA\u2010186107"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["CA\u2010176726"],"award-info":[{"award-number":["CA\u2010176726"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001861","name":"Forskningsr\u00e5det f\u00f6r Arbetsliv och Socialvetenskap","doi-asserted-by":"publisher","award":["2010\u20100674"],"award-info":[{"award-number":["2010\u20100674"]}],"id":[{"id":"10.13039\/501100001861","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","award":["R\u2010158031"],"award-info":[{"award-number":["R\u2010158031"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care & Research"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Objective<\/jats:title>To investigate whether menopausal factors are associated with the development of serologic rheumatoid arthritis (RA<\/jats:styled-content>) phenotypes.<\/jats:p><\/jats:sec>Methods<\/jats:title>Data were analyzed from the Nurses\u2019 Health Studies (NHS<\/jats:styled-content>; 1976\u20132010 and NHSII<\/jats:styled-content> 1989\u20132011). A total of 120,700 female nurses ages 30\u201355 years in the NHS<\/jats:styled-content>, and a total of 116,430 female nurses ages 25\u201342 years in the NHSII<\/jats:styled-content>, were followed via biennial questionnaires on lifestyle and disease outcomes. In total, 1,096 incident RA<\/jats:styled-content> cases were confirmed by questionnaire and chart review. Seropositive RA<\/jats:styled-content> was defined as rheumatoid factor positive (RF<\/jats:styled-content>) or antibodies to citrullinated protein antigen (ACPA<\/jats:styled-content>) positive, and seronegative RA<\/jats:styled-content> was defined as RF<\/jats:styled-content> negative and ACPA<\/jats:styled-content> negative. We used Cox proportional hazards models to obtain multivariable\u2010adjusted hazard ratios (HR<\/jats:styled-content>s) with 95% confidence intervals (95% CI<\/jats:styled-content>s) of seropositive\/seronegative RA<\/jats:styled-content> associated with menopausal status, age at menopause, type of menopause, ovulatory years, and postmenopausal hormone therapy (PMH<\/jats:styled-content>) use.<\/jats:p><\/jats:sec>Results<\/jats:title>Postmenopausal women had a 2\u2010fold increased risk of seronegative RA<\/jats:styled-content>, compared with premenopausal women (NHS<\/jats:styled-content>: HR<\/jats:styled-content> 1.8 [95% CI<\/jats:styled-content> 1.1\u20133.0], NHSII<\/jats:styled-content>: HR<\/jats:styled-content> 2.4 [95% CI<\/jats:styled-content> 1.4\u20133.9], and pooled HR<\/jats:styled-content> 2.1 [95% CI<\/jats:styled-content> 1.4\u20133.0]). Natural menopause at early age (\u226444 years) was associated with an increased risk of seronegative RA<\/jats:styled-content> (pooled HR<\/jats:styled-content> 2.4 [95% CI<\/jats:styled-content> 1.5\u20134.0]). None of the menopausal factors was significantly associated with seropositive RA<\/jats:styled-content>. We observed no association between PMH<\/jats:styled-content> use and the risk of seronegative or seropositive RA<\/jats:styled-content>, except that PMH<\/jats:styled-content> use of \u22658 years was associated with increased risk of seropositive RA<\/jats:styled-content> (pooled HR<\/jats:styled-content> 1.4 [95% CI<\/jats:styled-content> 1.1\u20131.9]).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Postmenopause and natural menopause at an early age were strongly associated with seronegative RA<\/jats:styled-content>, but only marginally with seropositive RA<\/jats:styled-content>, suggesting potential differences in the etiology of RA<\/jats:styled-content> subtypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23194","type":"journal-article","created":{"date-parts":[[2017,1,13]],"date-time":"2017-01-13T18:00:00Z","timestamp":1484330400000},"page":"1676-1684","source":"Crossref","is-referenced-by-count":74,"title":["Association Between Menopausal Factors and the Risk of Seronegative and Seropositive Rheumatoid Arthritis: Results From the Nurses\u2019 Health Studies"],"prefix":"10.1002","volume":"69","author":[{"given":"Camilla","family":"Bengtsson","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Malspeis","sequence":"additional","affiliation":[{"name":"Brigham & Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Orellana","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Brigham & Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen H.","family":"Costenbader","sequence":"additional","affiliation":[{"name":"Brigham & Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth W.","family":"Karlson","sequence":"additional","affiliation":[{"name":"Brigham & Women's Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2012.04.002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e328336474d"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.120899"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.126821"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60008-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201960"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1351.019"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.509"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780341205"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21900"},{"key":"e_1_2_8_13_1","first-page":"207","article-title":"The effect of oral contraceptives and estrogen replacement therapy on the risk of rheumatoid arthritis: a population based study","volume":"31","author":"Doran MF","year":"2004","journal-title":"J Rheumatol"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.084707"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20621"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.115964"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780350205"},{"key":"e_1_2_8_18_1","first-page":"171","article-title":"The onset of rheumatoid arthritis in relation to pregnancy and childbirth","volume":"11","author":"Lansink M","year":"1993","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203567"},{"key":"e_1_2_8_20_1","first-page":"1620","article-title":"Onset of symptoms of rheumatoid arthritis in relation to age, sex and menopausal transition","volume":"17","author":"Goemaere S","year":"1990","journal-title":"J Rheumatol"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.200059"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22494"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-015-0004-y"},{"key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1001\/jama.1986.03370100093024","article-title":"Noncontraceptive hormones and rheumatoid arthritis in perimenopausal and postmenopausal women","volume":"255","author":"Vandenbroucke JP","year":"1986","journal-title":"JAMA"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/03009740802448825"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23325"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(03)00084-2"},{"key":"e_1_2_8_28_1","first-page":"1473","article-title":"Does estrogen replacement therapy protect against rheumatoid arthritis?","volume":"18","author":"Spector TD","year":"1991","journal-title":"J Rheumatol"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330705"},{"key":"e_1_2_8_30_1","first-page":"911","article-title":"Postmenopausal hormones and the incidence of rheumatoid arthritis","volume":"16","author":"Carette S","year":"1989","journal-title":"J Rheumatol"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1590"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(94)00096-C"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.09.053"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.037580"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod60.5.1158"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24548"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1080\/08916930701464764"}],"container-title":["Arthritis Care & Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.23194","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.23194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T15:14:35Z","timestamp":1759418075000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.23194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,21]]},"references-count":38,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1002\/acr.23194"],"URL":"https:\/\/doi.org\/10.1002\/acr.23194","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,9,21]]}}}