Session Information
Date: Tuesday, November 7, 2017
Title: Rheumatoid Arthritis – Clinical Aspects Poster III: Comorbidities
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
The association of body mass index (BMI) with the outcomes of rheumatoid arthritis (RA) has been inconsistent in the literature. It is postulated that high BMI or obesity may have a diverse influence on RA risk, clinical activity and treatment response. The aim of our study is to investigate the association of BMI with RA disease activity and severity in a multi-ethnic RA cohort in Singapore.
Methods:
We reviewed data that was collected from November 2013 to March 2017 in a tertiary rheumatology centre. There were 288 patients (83.68% Chinese, 5.9% Malay, 9.72% Indian, 0.69% others; 87.85% female, 12.15% male). All patients fulfilled the ACR 1987 criteria for RA. Based on the World Health Organization classification, patients were categorized into 3 groups: low, normal and high BMI [<18.5kg/m² (underweight), 18.5-25kg/m² (normal weight) and >25kg/ m² (overweight) respectively]. Sociodemographic data, clinical features, disease activity (DAS28), laboratory variables (C-reactive protein, fasting lipid profile), functional status and co-morbidities were compared between the three BMI groups. Chi-square, T-test, Kruskal Wallis test and Wilcoxon rank sum test were used where appropriate. Statistical significance was defined as p-value < 0.05.
Results:
The mean age of the cohort was 44.7+11.85 years, the median RA duration 197.5 months, with no statistical difference between the three groups. Patients with normal BMI were the most likely to attain remission (DAS28<2.6) among the three groups (58.14% vs 81.43% vs 76.24%, p=0.038). Patients with normal BMI had a significantly lower C-reactive protein (mg/L) compared with the two other groups (4.1 vs 3.2 vs 4.6, p=0.0214). The low BMI group had a higher physician’s assessment of disease activity, but this did not reach statistical significance (12.47±18.13 vs 7.45±15.82 vs 9.18±18.51, p=0.236). The obese patients had significantly lower physical functioning scores in SF-36 (85 vs 75 vs 70, p=0.0198). Not unexpectedly, obese patients were more likely to have hypertension (p<0.0001), low HDL (p=0.004) and high TG (p=0.0001) levels, but there was no statistically significant difference for diabetes mellitus, ischemic heart disease, cardiovascular accident, liver and renal disease in the three groups. The three groups did not differ in gender, smoking status, prevalence of rheumatoid factor and anti-citrullinated peptide antibody, number of deformed joints, health assessment questionnaire (HAQ) scores and treatment.
Conclusion:
In our multi-ethnic cohort, patients with normal BMI appear to have the best RA control. High BMI should be considered a modifiable risk factor for poor RA outcome. Future studies should be done to investigate the relation of BMI and adiposity, as well as influence of frailty and sarcopenia on RA disease activity.
To cite this abstract in AMA style:
Teo C, Leong K, Woo C, Tang X, Tan JW, Lian T, Koh E. Low or High BMI Negatively Impacts RA Disease Activity in an Asian RA Cohort [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/low-or-high-bmi-negatively-impacts-ra-disease-activity-in-an-asian-ra-cohort/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/low-or-high-bmi-negatively-impacts-ra-disease-activity-in-an-asian-ra-cohort/