The Clinical Impact of Overweight in Rheumatoid Arthritis Patients: Comparison Between Korean and Other Countries within the Comora Study

Kichul Shin¹, Eun Young Ahn², Hyun Mi Kwon², In Ah Choi³, Yeonsoo Baik⁴ and Yeong Wook Song², ¹Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea, ²Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea, ³Division of Rheumatology, Department of internal medicine, Chungbook National University Hospital, Cheongju-si, South Korea, ⁴Division of Rheumatology, Department of internal medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Co-morbidities, obesity and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 9, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Obesity has recently been spotlighted as an important comorbidity in rheumatoid arthritis (RA); not only associated with disease severity but also its development. Despite that the long-term impact of obesity in RA should be studied in longitudinal studies, our aim was to investigate what clinical aspects of obese Korean RA patients would differ from those with normal body mass index (BMI) in a cross-sectional study.

Methods: COMORA is an international (17 countries), cross-sectional study investigating demographics, disease characteristics, and comorbidities (cardiovascular, infections, cancer, gastrointestinal, pulmonary, osteoporosis and psychiatric disorders) in RA patients. The Korean delegation consisting of 11 centers nationwide provided clinical data of total 1050 RA patients. We divided the RA patients into 2 groups (table); those with normal BMI (n= 834) versus (vs.) BMI equal to, or higher than 25 (abnormal BMI, n= 216).

Results: Demographic and medication data between normal vs. abnormal BMI were mostly comparable, but not for age (55.4 vs. 58.5, p= 0.0005) and education level (lower in the abnormal BMI group, p= 0.0072). Additional parameters were compared adjusting age, gender, disease duration, and education level. Disease activity at survey was similar between the 2 groups. Modified HAQ scores were significantly higher in patients with abnormal BMI (p= 0.028), and prevalence of hypertension, dyslipidemia were much higher in the abnormal BMI group, as expected. Additionally, data from the other 16 countries (COMORA-EK) was compared with Korean patients (COMORA-K). Interestingly, abnormal BMI patients in COMORA-EK showed higher disease activity (swollen, tender joint counts, DAS28-ESR, DAS28-CRP), which was not appreciated in COMORA-K.

Conclusion: These data demonstrate that overweight RA patients have worse functional status in general, yet abnormal BMI does not seem to affect disease activity in Korean patients to the degree observed in COMORA-EK.

Table. Selected clinical parameters from COMORA-K and -EK

Parameters	COMORA-K				COMORA-EK
Parameters	Normal BMI (n= 834)	Abnormal BMI (n= 216)	p-value	p-value*	Normal BMI (n= 1710)	Abnormal BMI (n= 1810)	p-value	p-value*
Body mass index	21.4 ± 2.1	27.5 ± 2.4	< 0.001		22.0 ± 2.1	30.2 ± 4.7	< 0.001
Age, years	55.4 ± 12.4	58.4 ± 11.1	0.0005		56.2 ± 14.3	56.4 ± 12.0	0.6018
Gender (female %)	83	82	0.6026		82	80	0.0882
Disease duration	7.0 ± 6.3	6.6 ± 6.2	0.4796		10.1 ± 9.2	9.6 ± 8.6	0.0811
Seropositivity, %	88	86	0.7686		83	80	0.3733
DAS28-ESR	3.51 ± 1.45	3.61 ± 1.41	0.3681	0.5496	3.61 ± 1.53	3.92 ± 1.52	< 0.001	0.0019
DAS28-CRP	2.72 ± 1.28	2.69 ± 1.20	0.8276	0.5807	3.31 ± 1.62	3.58 ± 1.65	< 0.001	0.0299
Modified HAQ	0.35 ± 0.50	0.46 ± 0.55	0.005	0.0282	0.49 ± 0.57	0.55 ± 0.57	0.0012	0.0004
EQ-5D-3L	0.76 ± 0.14	0.73 ± 0.16	0.0165	0.1073	0.75 ± 0.15	0.73 ± 0.15	< 0.001	< 0.001

Values are mean ± S.D.

BMI, body mass index; DAS, disease activity score; ESR, erythrocyte sedimentation rate; CRP, c-reactive protein; HAQ, health assessment questionnaire

*Adjusted by age, gender, disease duration, and education level

Disclosure: K. Shin, None; E. Y. Ahn, None; H. M. Kwon, None; I. A. Choi, None; Y. Baik, None; Y. W. Song, None.

To cite this abstract in AMA style:

Shin K, Ahn EY, Kwon HM, Choi IA, Baik Y, Song YW. The Clinical Impact of Overweight in Rheumatoid Arthritis Patients: Comparison Between Korean and Other Countries within the Comora Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-clinical-impact-of-overweight-in-rheumatoid-arthritis-patients-comparison-between-korean-and-other-countries-within-the-comora-study/. Accessed .

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