Obesity is associated with more severe rheumatoid arthritis, and more comorbidities

http://www.ncbi.nlm.nih.gov/pubmed/22514159

Arthritis Care Res (Hoboken). 2012 Apr 18. doi: 10.1002/acr.21710. [Epub ahead of print]

Obesity is associated with worse disease severity in rheumatoid arthritis as well as with co-morbidities - a long-term follow-up from disease onset.

Ajeganova S, Andersson ML, Hafström I; for the BARFOT study group.

Source

Unit of Rheumatology, Department of Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.

Abstract

OBJECTIVE:

To determine the association of obesity, defined as BMI≥30 or ≥28 kg/m(2) or by waist circumference (WC), on disease activity and severity as well as its relation to comorbidities in rheumatoid arthritis (RA).

METHODS:

The study population comprised 1596 patients with early RA, mean(SD) age 55.6(14.6) years, 67.8% women, who had been included in the BARFOT observational study 1992-2006. In 2010, data on life-style factors and comorbidities were collected through a postal questionnaire, answered by 1391 patients. Clinical outcomes were DAS28, sustained remission, physical function (HAQ), VAS pain and global health, as well as predefined comorbidities.

RESULTS:

After mean(SD) of 9.5(3.7) years, BMI had increased from 25.4(4.2) to 26.0(4.5) kg/m(2) , p=0.000. The prevalence of BMI≥30 was 12.9% at baseline and 15.8% at follow-up. In multivariable regression, BMI and obesity defined as BMI>30 or >28, at both inclusion and at survey were independently associated with higher disease activity, fewer in sustained remission, higher HAQ, more pain and worse general health. Also, BMI and obesity independently conferred to higher odds for being diagnosed with hypertension, diabetes mellitus and chronic pulmonary disease. Further, BMI and WC were independently associated with angina pectoris/AMI/coronary revascularization. In contrast, none of the examined obesity variables conferred to prevalence of stroke or transient ischemic attack. Life-style changes during observational period, as quit smoking or diet change, had no impact on the outcomes.

CONCLUSION:

Obesity was associated with worse RA-disease outcomes and higher prevalence of comorbidities. Body measurements are recommended to improve prediction of disease course.