Country-level socioeconomic status relates geographical latitude to the onset of rheumatoid arthritis (RA): a worldwide cross-sectional analysis in the METEOR registry
Authors' conclusion
Patients living closer to the equator get RA at a younger age. This latitude gradient was not explained by individual patient characteristics, but rather by countries' socioeconomic status, providing a direct link between countries' level of welfare and the clinical onset of RA.
Study context
- Population
- Patients with RA from the worldwide METEOR registry, 93 hospitals in 17 countries
- Participants
- 37,981 patients93 hospitals17 countries
- Outcome
- Relationship between absolute (hospital) geographical latitude and age at diagnosis (proxy for age at RA onset)
Methodological detailsworldwide registry (METEOR), Bayesian multilevel structural equation models
- Worldwide registry (METEOR)
- Bayesian multilevel structural equation models
Main finding
As reported in the abstract
Change in mean age at diagnosis per degree increase in country latitude (9.9°–55.8°)
- Increase in mean age at diagnosis per degree latitude
- 0.23 (years; 95% CrI 0.095 to 0.38; >10 years difference in age at RA onset)
- Latitude effect for hospitals within a country
- negligible
Observational data: associations, not effects.
Further findings
Mean age at diagnosis per country (range)
Latitude effect after inclusion of patient-specific factors (eg, gender, ACPA status)
- Main effect augmented from 0.23 to (years)
- 0.36
Latitude effect after inclusion of country-level socioeconomic indicators (eg, GDP per capita)
- Main effect almost effaced, from 0.23 to (years; −0.37 to 0.38)
- 0.051
Original publication
Country-level socioeconomic status relates geographical latitude to the onset of RA: a worldwide cross-sectional analysis in the METEOR registry. Ann Rheum Dis. Published 25 May 2023. doi:10.
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