Background Obesity is a mild, long-lasting inflammatory disease and, as such, could increase the inflammatory burden of rheumatoid arthritis (RA).
Objectives We aimed to estimate the prevalence of underweight, overweight and obese in Turkish patients with RA and its relationships with disease activity, functional disability, quality of life, structural damage, and laboratory parameters
Methods The study population compromised 1,038 of patients with RA (mean ± SD age 56.09±12.63 years, 81% women) who had been included in TRASD (Türkiye Romatizma Araştırma ve Savaş Derneği)-IP Registry. DAS28, CDAI, SDAI, BMI (kg/m2), acute-phase reactants, IgM-RF, anti-CCP antibody, complete blood count, and blood biochemistry values were collected. Other parameters were Sharp-vanderHeijde score, physical function (HAQ), quality of life (RAQoL), as well as pain, fatigue, general health, patient and physician global health assessed on a visual analog scale.
Results Patients have 10.23±8.78 (1-53) years of disease duration and 3.67±1.56 of mean DAS28 (0.42-7.91) scores. The mean score of HAQ was 0.99±0.72 (0.17-3). And mean score of the RA quality of life (RAQoL) was 12.28±10.08 (0-30). According to the BMI, 1.25% (n=13) of patients were underweight, 28.23% (n=293) patients were in normal limits, 34.87% (n=362) patients were overweight, and 35.07% (n=364) of patients were obese. Obese patients had higher scores of DAS28, pain, and patient global, and higher level of fasting blood glucose, but lower radigraphic score of Sharp vdH than normal patients in multiple comparisons of ANOVA (p<0.05). BMI was associated positively with the older age (r=0.135), older age onset (r=0.116), female sex (r=0.104), DAS28 (r=0.212), pain (r=0.085), patients' global (r=0.094), ESR (p=0.087), ALT (p=0.115), LDH ((r=0.201), trigliserid (r=0.152), (p<0.01) and negatively with Sharp vdH radiographic score (r=-0.158) (p<0.01). Linear regression analyses showed that the BMI was independently and inversely associated with the level of joint destruction and positively associated with DAS28.
Conclusions Obesity was associated with higher disease activity and lower radiographic scores of small joints. Despite reported conflicting results, obesity may have protective effect on the amount of destruction in small joints of the hands and feet (1,2). Routine body mass index measurements, healthy diet and regular exercise should be recommended to improve outcomes of the disease course as well as pharmacologic treatments.
van der Helm-van Mil AH, van der Kooij SM, Allaart CF, Toes RE, Huizinga TW. A high body mass index has a protective effect on the amount of joint destruction in small joints in early rheumatoid arthritis. Ann Rheum Dis. 2008;67(6):769-74.
Ibn Yacoub Y, Amine B, Laatiris A, Wafki F, Znat F, Hajjaj-Hassouni N. Prevalence of overweight in Moroccan patients with rheumatoid arthritis and its relationships with disease features. Clin Rheumatol. 2012;31(3):479-82.
Disclosure of Interest None declared