A population-based study on the association between rheumatoid arthritis and voice problems

Area of Science:

• Otolaryngology
• Rheumatology
• Public Health

Background:

• Rheumatoid arthritis (RA) is a systemic autoimmune disease.
• Potential extra-articular manifestations of RA are being increasingly recognized.
• The impact of RA on laryngeal health and voice quality requires further investigation.

Purpose of the Study:

• To determine if rheumatoid arthritis increases the incidence of organic laryngeal lesions.
• To assess if rheumatoid arthritis elevates the rate of subjective voice complaints.
• To differentiate between RA-related and confounding factor-related voice issues.

Main Methods:

• Cross-sectional study utilizing data from the Korea National Health and Nutrition Examination Survey (2008-2011).
• Inclusion of 418 rheumatoid arthritis patients and 18,950 controls.
• Analysis using simple and multiple logistic regression, adjusting for age, sex, smoking, stress, and BMI.

Main Results:

• Rheumatoid arthritis showed a positive association only with laryngitis (aOR=1.59, 95% CI=1.01-2.52, P=0.047).
• No significant association was found between RA and vocal nodules, polyps, or palsy.
• While RA patients reported subjective voice discomfort in simple analysis, this association disappeared in multiple regression, indicating confounding factors.

Conclusions:

• Rheumatoid arthritis is not a significant risk factor for most organic laryngeal lesions or subjective voice complaints.
• Laryngitis is the only laryngeal condition positively associated with RA.
• Voice complaints in RA patients are likely attributable to demographic and lifestyle factors (older age, female sex, higher stress) prevalent in the RA cohort, rather than RA itself.