Background/Purpose: Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic arthritis that mainly affects small and medium joints. It is the most common form of inflammatory arthritis, capable of producing significant joint damage, deformity and functional disability. An association between increased body mass index (BMI) and some inflammatory and autoimmune conditions have been suggested in observational studies. Adipose tissue is considered as an active participant in physiological and pathological processes associated with inflammation and immunity. Evidence suggests that the effect of obesity on joint structure goes beyond overload, which is based on multiple complex factors such as cytokines, hormones, growth factors and intracellular regulators that can modify the course of disease and clinical response; so we set as main objective to assess activity indices in patients with rheumatoid arthritis and its relationship with BMI.

Methods: Descriptive cross-sectional study, in which 3,858 patient records were analyzed in the period from January 2012 to January 2016; 1,235 met RA criteria by the American College of Rheumatology (ACR) 2010, 131 patients met criteria for inclusion, it was assessed patient’s age, sex, BMI, index of disease activity in 28 joints (DAS28), erythrocyte sedimentation rate, disease-modifying drugs (DMARDs) and glucocorticoids, data was obtained in the second visit. SPSS V.22 was employed for Windows 8, developing a database with the aforementioned variables, descriptive statistical analysis was performed with frequencies and percentages, crossed tables were made to establish association between different variables and finally to analyze age, mean and standard deviation (SD) were used.

Results: Females accounted for 96.2%, the average age was 56.48 ± 12 years, 33.5% of patients were overweight, 11.5% obesity class I, class II obesity for a 5.3%, 0.8% class III obesity; 51.1% had a BMI above normal levels; 48.9% were in normal range, 6% achieved remission in normal weight and 1.5% in the scale of overweight; in terms of low activity in normal weight was 6.6% versus 6% with high BMI; 29% was found in moderate activity in normal weight and 22.9% in the high BMI, 10% in normal weight had high activity, compared with 18% of increased BMI patients, the DMARD most used was methotrexate, the most common glucocorticoid used was prednisone.

Conclusion: In our population, we found that higher BMI limits the possibility of achieving low activity or remission and increased BMI was associated with higher doses of DMARDs and glucocorticoids. Prospective studies with more patients, longer follow-up are necessary and remind patients the importance of maintaining an adequate body mass index for better control of their disease.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-obesity-activity-indices-and-therapeutic-dosage-in-patients-with-rheumatoid-arthritis-in-dominican-republic/