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Background <p>Patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) face a significantly elevated mortality risk. However, the association between rheumatoid factor (RF) and RA-ILD remains unclear. This study aimed to investigate the relationship between RF and RA-ILD risk, with a focus on potential nonlinear associations and threshold effects.</p> Methods <p>A single-center retrospective cohort of 4,736 rheumatoid arthritis (RA) patients (January 2014–December 2024) was analyzed. Propensity score matching (PSM, 1:1) was applied to control for confounding factors. Multivariate logistic regression and restricted cubic spline (RCS) models were used to evaluate the association between RF levels and RA-ILD risk.</p> Results <p>After PSM, 1,018 patients (509 RA-ILD and 509 non-ILD) were included. Multivariate analysis confirmed RF positivity as an independent risk factor for RA-ILD (adjusted OR = 1.506, 95% CI: 1.101–2.061,&#xa0;<i>P</i> = 0.010). A significant nonlinear relationship was observed (<i>P</i> &lt; 0.0001), with a risk threshold identified at 60&#xa0;IU/mL.</p> Conclusion <p>RF positivity is an independent risk factor for RA-ILD, demonstrating a nonlinear threshold effect. Clinical practice should emphasize regular RF monitoring and enhanced ILD screening and follow-up, particularly for patients with persistently elevated RF levels.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> <p><b>Key Points</b></p> <p>• <i>RF Positivity is an Independent Risk Factor for RA-ILD.</i></p> <p>• <i>Paradoxical Risk Reduction at Extremely High RF Levels.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>

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Nonlinear association between rheumatoid factor and interstitial lung disease risk in patients with rheumatoid arthritis

  • 期刊论文

  • 发表日期：

    2025年8月5日

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  • Suiran Li,
  • Jiamin Zhang,
  • Jianbin Li,
  • Wei Liu

摘要

Background

Patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) face a significantly elevated mortality risk. However, the association between rheumatoid factor (RF) and RA-ILD remains unclear. This study aimed to investigate the relationship between RF and RA-ILD risk, with a focus on potential nonlinear associations and threshold effects.

Methods

A single-center retrospective cohort of 4,736 rheumatoid arthritis (RA) patients (January 2014–December 2024) was analyzed. Propensity score matching (PSM, 1:1) was applied to control for confounding factors. Multivariate logistic regression and restricted cubic spline (RCS) models were used to evaluate the association between RF levels and RA-ILD risk.

Results

After PSM, 1,018 patients (509 RA-ILD and 509 non-ILD) were included. Multivariate analysis confirmed RF positivity as an independent risk factor for RA-ILD (adjusted OR = 1.506, 95% CI: 1.101–2.061, P = 0.010). A significant nonlinear relationship was observed (P < 0.0001), with a risk threshold identified at 60 IU/mL.

Conclusion

RF positivity is an independent risk factor for RA-ILD, demonstrating a nonlinear threshold effect. Clinical practice should emphasize regular RF monitoring and enhanced ILD screening and follow-up, particularly for patients with persistently elevated RF levels.

Key Points

• RF Positivity is an Independent Risk Factor for RA-ILD.

• Paradoxical Risk Reduction at Extremely High RF Levels.