Jesús A Valero-Jaimes1, Ruth López-González2, María A Martín-Martínez3, Carmen García-Gómez4, Fernando Sánchez-Alonso3, Jesús T Sánchez-Costa3, Carlos González-Juanatey5, Eva Revuelta-Evrad6, César Díaz-Torné7, Cruz Fernández-Espartero8, Carolina Pérez-García9, Vicenç Torrente-Segarra10, Ginés Sánchez-Nievas11, Trinidad Pérez-Sandoval12, Pilar Font-Ugalde13, María L García-Vivar14, Elena Aurrecoechea15, Olga Maiz-Alonso1, Ramón Valls-García16, José A Miranda-Filloy17, Javier Llorca18, Santos Castañeda19, Miguel A Gonzalez-Gay20,21,22. 1. Division of Rheumatology, Hospital Universitario de Donosti, 20014 San Sebastián, Spain. 2. Division of Rheumatology, Hospital Universitario Hospital General Virgen de la Concha, 49022 Zamora, Spain. 3. Research Unit of Spanish Society of Rheumatology, 28001 Madrid, Spain. 4. Division of Rheumatology, Consorci Sanitari de Terrassa, Terrassa, 08191 Barcelona, Spain. 5. Division of Cardiology, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain. 6. Division of Rheumatology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain. 7. Division of Rheumatology, Hospital de la Santa Creu I Santa Pau, 08041 Barcelona, Spain. 8. Division of Rheumatology, Hospital Universitario de Móstoles, 28935 Madrid, Spain. 9. Division of Rheumatology, Hospital del Mar, 08003 Barcelona, Spain. 10. Division of Rheumatology, Hospital Comarcal Alt Penedès Garraf, 08720 Barcelona, Spain. 11. Division of Rheumatology, Complejo Hospitalario Universitario de Albacete, 02006 Albacete, Spain. 12. Division of Rheumatology, Complejo Asistencial Universitario de León, 24071 León, Spain. 13. Division of Rheumatology, Hospital Universitario Reina Sofía, 14004 Córdoba, Spain. 14. Division of Rheumatology, Hospital Universitario Basurto, 48013 Bilbao, Spain. 15. Division of Rheumatology, Hospital de Sierrallana, 39300 Santander, Spain. 16. Division of Rheumatology, Hospital Universitario de Palamós, 17230 Barcelona, Spain. 17. Division of Rheumatology, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain. 18. University of Cantabria and CIBER Epidemiología y Salud Pública (CIBERESP), 39005 Santander, Spain. 19. Division of Rheumatology, Hospital Universitario de la Princesa, IIS-Princesa, EPID-Future, Universidad Autónoma de Madrid (UAM), 28006 Madrid, Spain. 20. Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, 39008 Santander, Spain. 21. Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, 39011 Santander, Spain. 22. Cardiovascular Pathophysiology and Genomics Research Unit, Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg 2050, South Africa.
Abstract
OBJECTIVE: Since obesity has been associated with a higher inflammatory burden and worse response to therapy in patients with chronic inflammatory rheumatic diseases (CIRD), we aimed to confirm the potential association between body mass index (BMI) and disease activity in a large series of patients with CIRDs included in the Spanish CARdiovascular in rheuMAtology (CARMA) registry. METHODS: Baseline data analysis of patients included from the CARMA project, a 10-year prospective study of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) attending outpatient rheumatology clinics from 67 Spanish hospitals. Obesity was defined when BMI (kg/m2) was >30 according to the WHO criteria. Scores used to evaluate disease activity were Disease Activity Score of 28 joints (DAS28) in RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AS, and modified DAS for PsA. RESULTS: Data from 2234 patients (775 RA, 738 AS, and 721 PsA) were assessed. The mean ± SD BMI at the baseline visit were: 26.9 ± 4.8 in RA, 27.4 ± 4.4 in AS, and 28.2 ± 4.7 in PsA. A positive association between BMI and disease activity in patients with RA (β = 0.029; 95%CI (0.01- 0.05); p = 0.007) and PsA (β = 0.036; 95%CI (0.015-0.058); p = 0.001) but not in those with AS (β = 0.001; 95%CI (-0.03-0.03); p = 0.926) was found. Disease activity was associated with female sex and rheumatoid factor in RA and with Psoriasis Area Severity Index and enthesitis in PsA. CONCLUSIONS: BMI is associated with disease activity in RA and PsA, but not in AS. Given that obesity is a potentially modifiable factor, adequate control of body weight can improve the outcome of patients with CIRD and, therefore, weight control should be included in the management strategy of these patients.
OBJECTIVE: Since obesity has been associated with a higher inflammatory burden and worse response to therapy in patients with chronic inflammatory rheumatic diseases (CIRD), we aimed to confirm the potential association between body mass index (BMI) and disease activity in a large series of patients with CIRDs included in the Spanish CARdiovascular in rheuMAtology (CARMA) registry. METHODS: Baseline data analysis of patients included from the CARMA project, a 10-year prospective study of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) attending outpatient rheumatology clinics from 67 Spanish hospitals. Obesity was defined when BMI (kg/m2) was >30 according to the WHO criteria. Scores used to evaluate disease activity were Disease Activity Score of 28 joints (DAS28) in RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AS, and modified DAS for PsA. RESULTS: Data from 2234 patients (775 RA, 738 AS, and 721 PsA) were assessed. The mean ± SD BMI at the baseline visit were: 26.9 ± 4.8 in RA, 27.4 ± 4.4 in AS, and 28.2 ± 4.7 in PsA. A positive association between BMI and disease activity in patients with RA (β = 0.029; 95%CI (0.01- 0.05); p = 0.007) and PsA (β = 0.036; 95%CI (0.015-0.058); p = 0.001) but not in those with AS (β = 0.001; 95%CI (-0.03-0.03); p = 0.926) was found. Disease activity was associated with female sex and rheumatoid factor in RA and with Psoriasis Area Severity Index and enthesitis in PsA. CONCLUSIONS: BMI is associated with disease activity in RA and PsA, but not in AS. Given that obesity is a potentially modifiable factor, adequate control of body weight can improve the outcome of patients with CIRD and, therefore, weight control should be included in the management strategy of these patients.
Entities:
Keywords:
ankylosing spondylitis; body mass index; obesity; psoriatic arthritis and disease activity; rheumatoid arthritis
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