Background Obesity is at now considered as a mild, long-lasting inflammatory disease associated with an increased cardiovascular (CV) risk. On the other hand, rheumatic diseases have been associated with increased CV risk, and there is an increasing interest regarding the prevalence and the effects of obesity and metabolic syndrome in such patients. Moreover, some rheumatic diseases can induce cachexia or malnutrition, as a consequence of both chronic inflammation or gastrointestinal impairment.
Objectives To evaluate the prevalence of overweight, obesity and metabolic syndrome (MS) in different cohorts of patients affected by the most representative inflammatory, autoimmune and vascular diseases, i.e. Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc).
Methods Body mass index (BMI) was assessed in 564 RA (346 early RA-ERA patients, 218 long standing RA-LSRA with severe disease requiring biologic treatment), 452 SLE patients and 296 SSc patients. BMI was categorized into 3 classes, i.e <25 kg/m2 (normal weight), 25-30 kg/m2 (overweight), and >30 kg/m2 (obese). Underweight patients (BMI<18.5 kg/m2) were also considered. Levels of total cholesterol, HDL-cholesterol, triglycerides, fasting glucose were evaluated, as well as the presence of arterial hypertension and diabetes mellitus. Metabolic syndrome was defined according to the American Heart Association/Updated NCEP criteria (1). We considered central obesityas a BMI>24 kg/m2 for women and BMI>25 kg/m2 for men (2) (data on waist-circumference were not availablefor all patients).
Results In the ERA cohort (76.3% female, age 54.6±14.0, disease duration <12 months, mean 5.8±3.5 months), 48.6% of subjects were normal weight, 39% overweight, 12.4% obese, with a mean BMI of 25.3±4.4, and the prevalence of MS was 25.3%; ten patients (2.3%) were underweight. The LSRA (81.2% female, age 58.6±13.1, disease duration 15.2±10.1) had a mean BMI of 25.1±4.5, 52.3% of patients were normal, 34.9% overweight and 12.8% obese; the MS was present in 27% of subjects; the underweight subjects were 4.1%. SLE patients (90.3% female, age 44.1±14.8 years, disease duration 11.6±8.3 years) had a BMI of 24.0±4.6 and 63% were normal weight, 27% overweight and 10% obese; underweight subjects were 8.9%; the MS was observed in 31.3%. In SSc cohort (88.2% female, age 58.5±14.2 years, disease duration 11.4±8.6 years) the mean BMI was 24.4±4.8 and the prevalence of obesity was 10.4%. 136 SSc patients (46.1%) were normal-weight, 125 (42.2%) were overweight, while only 4 (1.3%) were underweight; the prevalence of metabolic syndrome was 14.2%.
Conclusions Obesity and metabolic syndrome are present in an important percentage of patients and should be taken into account as targets at risk for CV diseases.
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Disclosure of Interest None Declared