ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1231

Rheumatoid Arthritis Is Associated with Likelihood of Being Overweight in Women

Irum-Mona Idrees1, H. Lester Kirchner2 and Androniki Bili1, 1Rheumatology, Geisinger Medical Center, Danville, PA, 2Geisinger Center for Health Research, Geisinger Health System, Danville, PA

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects II: Clinical Features & Comorbidity/Cardiovascular Disease

Session Type: Abstract Submissions (ACR)

Background/Purpose: Adipose tissue is metabolically active producing adipokines, which, along with locally attracted cytokines, are active participants in inflammation and its regulation. Since RA a systemic inflammatory disease, we postulated that obesity might be a risk factor for developing RA. The objective of this study was to evaluate the association of obesity with risk of incident RA.     Methods: We conducted a case control study using incident RA cases from 2001 to 2011 in a health system using electronic health records. Patients with a primary care physician in the health system with at least 3 documented body mass index (BMI, in kg/m2) measurements were eligible. A 1:5 (case:control) age, gender, and calendar year match design was performed. An index date was created such that for cases it was the date of RA diagnosis and for the controls it was the date of RA diagnosed in the matching case.  Current obesity was defined using the most recent prior, BMI measurement to the index date.  History of obesity was defined using all historical BMI measurements, prior to the index date.  Any prior BMI >30 was considered as meeting criteria.  This was repeated for current and history of overweight classification (BMI > 25).   The association between BMI in RA patients and the controls was calculated using a conditional logistic regression model adjusting for current smoking status.     Results: 523 patients with incident RA and 2615 age, gender, calendar year matched controls were included in the analysis. The baseline characteristics revealed similar average BMI measurements in the two groups; current and past smoking was more prevalent in the RA group than controls. Of the RA patients, 63% and 41% were positive for RF and ACPA, respectively. The odds ratio (OR) for the association between RA and obesity or overweight overall, and stratified by gender, is shown in Table 1. Subgroup analysis according to RF positivity is shown in Table 2. Similar results were found for ACPA positivity.     Conclusion: RA is associated with 43% and 31% increase in odds of historical or current overweight status in women. This is consistent with other previously reported data and it is a significant observation that can help shed light in the pathogenesis of RA. Further, the observed association of being currently overweight or historically overweight or obese with specifically sero-negative RA may be relevant to the reported protective effect of a higher BMI on joint erosion in RA.  These results need to be replicated in prospective RA cohorts.

Table 1. Odds of obesity or overweight in RA patients according to gender

 

All

Female

Male

 

OR (95% CI)

P-Value

OR (95% CI)

P-Value

OR (95% CI)

P-Value

BMI

1.01 (0.99, 1.02)

0.19

1.01 (1.00, 1.03)

0.12

0.99 (0.96, 1.03)

0.73

Current Obesity

1.07 (0.88, 1.29)

0.50

1.21 (0.97, 1.51)

0.10

0.79 (0.56, 1.12)

0.19

History of Obesity

1.18 (0.98, 1.43)

     0.08

1.24 (0.99, 1.56)

       0.06

1.04 (0.74, 1.48)

      0.81

Current Overweight

1.31 (1.03, 1.66)

0.03

1.38 (1.05, 1.82)

0.02

1.11 (0.68, 1.80)

0.67

History of Overweight

1.43 (1.09, 1.88)

0.01

1.60 (1.17, 2.18)

0.003

0.92 (0.52, 1.62)

0.77

Table 2. Odds of RF positivity in RA patients according to gender

 

RF-negative vs. Control

RF-positive vs. Control

 

OR (95% CI)

P-Value

OR (95% CI)

P-Value

BMI

1.03 (1.00, 1.05)

0.04

1.00 (0.99, 1.02)

0.72

Current Obesity

1.18 (0.86, 1.62)

0.30

1.01 (0.79, 1.29)

0.93

History of Obesity

1.44 (1.04, 2.01)

       0.03

1.05 (0.83, 1.34)

     0.69

Currently Overweight

1.68 (1.09, 2.58)

0.02

1.15 (0.85, 1.54)

0.37

History of Overweight

1.72 (1.06, 2.78)

0.03

1.22 (0.87, 1.71)

0.25

 

Disclosure:

I. M. Idrees,
None;

H. L. Kirchner,
None;

A. Bili,
None.

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatoid-arthritis-is-associated-with-likelihood-of-being-overweight-in-women/