Background/Purpose:

Over one-third of U.S. adults are obese, leading to major health conditions and increased costs. Identified risk factors that contribute to obesity include lifestyle, genetics and childhood diseases. Using data from the National Health and Nutrition Examination Survey (NHANES), we investigated whether the risk of obesity in adults associates with juvenile arthritis.

Methods:

We linked NHANES 2007-2014 datasets to assess the obesity status of respondents reporting any type of arthritis diagnosed prior to 18 years of age and compared them to a group of respondents with asthma diagnosed prior to 18 years of age (participants with both diseases were excluded from the analyses).

Body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, and was used to characterize obesity status. Using federal BMI-defined obesity categories (normal weight (18.5-24.9 kg/m²), overweight (25-29.9 kg/m²), obese (≥30 kg/m²) and extreme obesity (≥40 kg/m²), we conducted logistic regression analyses controlling for age, gender and race, was used to estimate the odds ratio (OR) of obesity or extreme obesity, incorporating sample weight to account for the complex sampling design.

Results:

There were 294 respondents who reported being diagnosed with juvenile arthritis (JA) and 4232 who reported a diagnosis of childhood asthma. Participants with JA were older (45.9 vs. 37.2 years, p<0.01), female (59% vs. 45%, p<0.01), and Caucasian (74% vs. 53%, p<0.01) compared to those with childhood asthma. Adults with history of JA were shorter (168.4 vs. 170.5 cm, p=0.02) and had higher body weight (86.2 vs. 84.1 kg, p=0.04). There was also a trend towards higher BMI in the JA group (30.3 vs. 28.9 kg/m², p =0.07). Unadjusted OR of obesity in the JA group were 1.2 (95% Confidence Interval (CI): 0.7-2.1) and adjusted OR was 0.9 (95% CI: 0.5-1.7). The odds of extreme obesity in the JA group compared to asthma group was almost double with unadjusted OR of 2.4 (95% CI: 1.2-4.8, p=0.02) and adjusted OR of 2.2 (95% CI: 0.9-5.7, p=0.09).

Conclusion:

A diagnosis of childhood arthritis independently associated with an increased risk of extreme obesity in adulthood. Our results may have been influenced by recall bias (i.e., misreporting age of diagnosed arthritis or asthma diagnosis). We were also unable to assess whether JA was still active in the adults. Nonetheless, our results suggest that factors related to having JA (e.g., inflammation, decreased physical activity, medical treatment) might contribute to developing extreme obesity in adulthood.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/increased-risk-of-extreme-obesity-in-adults-with-history-of-childhood-arthritis/