Background/Purpose: Obesity has been implicated as a risk factor in developing various cardiovascular, respiratory, and other health complications. However, the link between obesity and autoimmune diseases is underrecognized. This study investigates the prevalence of obesity in patients with autoimmune diseases and evaluates the risks of autoimmune diseases in obese patients using a large national database.

Methods: Patients aged 18 or older, hospitalized between 2016 and 2019, with and without obesity (defined as a body mass index ≥30), and diagnosed with an autoimmune condition, including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and dermatomyositis, were identified from the National Inpatient Sample (NIS) database using the International Classification of Diseases, Tenth Revision (ICD-10) codes. Prevalence rates of obesity in patients with different autoimmune diseases were calculated. The adjusted odds ratios (AORs) for autoimmune diseases in obese patients were determined using logistic multivariate regression analysis, controlling for age, race, sex, and other comorbidities to assess the associations between autoimmune diseases and obesity.

Results: Over 13 million patients with obesity were identified. The prevalence of obesity in patients with autoimmune diseases varied, with notable findings in rheumatoid arthritis (14.66%), systemic lupus erythematosus (14.73%), and psoriatic arthritis (19.93%). Patients with obesity had higher odds of developing psoriatic arthritis (AOR 1.92, 95% Confidence Interval [CI]: 1.65-2.23, p < 0.001), rheumatoid arthritis (AOR 1.29, 95% CI: 1.28-1.30, p < 0.001), dermatomyositis (AOR 1.12, 95% CI: 1.03-1.21, p = 0.011), and systemic lupus erythematosus (AOR 1.17, 95% CI: 1.15-1.18, p < 0.001). Conversely, obese patients had lower odds of having systemic sclerosis (AOR 0.54 CI: 0.51-0.56, p < 0.001). These associations remained statistically significant after adjusting for age, sex, and other comorbidities.

See Figure 1 for prevalence rates and Figure 2 for the adjusted odds ratios displayed in a Forest plot.

Conclusion: This retrospective study demonstrates an association between obesity and the risk of developing certain autoimmune diseases. Further research is needed to explore the underlying mechanisms linking adiposity and autoimmune diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/obesity-and-risk-of-autoimmune-diseases-insights-from-the-national-inpatient-sample/