Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose:
Body mass index (BMI) is a predictor of long-term outcome in rheumatoid arthritis and has been associated with joint damage. Our objective was to examine the association between changes in body mass and joint damage in a cohort of rheumatoid arthritis patients.
Methods:
From 1996 to 2009, we recruited 1328 consecutive patients who met the 1987 criteria for RA from private and public rheumatology practices in San Antonio, Texas. All patients participated in a comprehensive baseline evaluation of their clinical and psychosocial characteristics conducted by a physician and trained research assistants and yearly follow up evaluations in which we assessed clinical and laboratory features.
We included the following variables in the analysis: age of RA onset, duration of RA, sex, ethnicity, DAS28 ESR, smoking and current use of steroids. Joint damage was measured using a radiograph of the hands, scored according to Sharp technique. Body mass was measured using the height and weight, expressed as Kg/M2.
Statistical Analysis:
We used cross-sectional time- series, generalized estimating equation regression models including all follow up visits to estimate independent associations between variables and body mass change over time.
Results:
We studied 1328 patients (347 male, 981 female) who participated in 3609 evaluations during a period of 8338 person- years. During this time body mass was lost at a rate of 0 .26 Kg/M2 per 5 years (p<0.0001). The body mass of patients in the lowest joint damage tertile remained stable, with a rate of change of -0.011 Kg/M2 per 5-years. By comparison, patients in the highest damage quartile lost body mass at a rate of 0.29 Kg/M2 per 5 years (p<.0001). Other variables independently associated with lower BMI were age of RA onset, smoking, and non-Hispanic White ethnicity. Current use of steroids and the DAS28ESR were not associated with changes in BMI or the risk of weight loss independent of other factors. When we divided the sample into tertiles according with the sharp score, the association with body mass displayed a dose-response pattern, with higher sharp scores associated with lower body mass (Table 1).
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Table 1. Rate of body mass loss according to the sharp score |
||
|
Sharp Score |
Rate of body mas loss (Kg/M2) per 5 year(95% CI) |
p-value |
|
0 – 23 |
-0.011 (-0.17, 0.20) |
Ref |
|
24 – 85 |
-0.23 (-0.39, -0.069) |
<0.005 |
|
86 – 471 |
-0.29 (-0.44, -0.14) |
<0.0001 |
Conclusion:
Joint damage was associated with loss of body mass in this RA cohort, with the greatest loss observed among patients with the most severe joint damage. Active smoking, age of onset of RA, duration of RA and white ethnicity were also associated with greater loss of body mass over time. This provides evidence of the systemic effects of joint inflammation.
To cite this abstract in AMA style:
Restrepo JF, del Rincon I, Battafarano D, Escalante A. Joint Damage Associated with Loss of Body Mass in Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/joint-damage-associated-with-loss-of-body-mass-in-rheumatoid-arthritis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/joint-damage-associated-with-loss-of-body-mass-in-rheumatoid-arthritis/