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Underweight and obese states both associate with worse disease activity and physical function in patients with established rheumatoid arthritis

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Abstract

Obesity is characterised by low-grade inflammation and could potentially affect disease activity and severity in patients with rheumatoid arthritis (RA). Body mass index (BMI), body fat (BF), erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, physical function (health assessment questionnaire) and presence of erosions and joint surgery were assessed in 294 (female = 219) volunteers with established RA [age 63.3 (56.2–69.6); disease duration 13 (7–20) years]. Smoking status, rheumatoid factor and anti-cyclic citrullinated peptide positivity were also assessed. BMI and BF independently associated with disease characteristics. Compared to normal-weight patients, underweight and obese had higher C-reactive protein (p = 0.046) and physical dysfunction (p = 0.034). BMI or BF did not associate with presence of erosions or joint surgery. In patients with established RA, both very low and very high BMI and BF associate independently with increased disease activity and physical dysfunction; however, this does not seem to associate with presence of erosions or joint surgery. Further longitudinal studies are required to address this apparent dissociation.

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Acknowledgements

This study was funded by the Dudley Group of Hospitals R&D directorate cardiovascular programme grant and a Wolverhampton University equipment grant. The Department of Rheumatology, Dudley Group of Hospitals, has an infrastructure support grant from the Arthritis Research Campaign (number 17682).

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Authors and Affiliations

  1. School of Sport, Performing Arts and Leisure, Wolverhampton University, Gorway Road, Walsall, WS1 3BD, West Midlands, UK

    Antonios Stavropoulos-Kalinoglou, Giorgos S. Metsios, Alan M. Nevill & Yiannis Koutedakis

  2. Research Institute in Healthcare Science, University of Wolverhampton, Wulfruna Street, Wolverhampton, WV1 1LY, West Midlands, UK

    Antonios Stavropoulos-Kalinoglou, Giorgos S. Metsios, Alan M. Nevill & George D. Kitas

  3. Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Pensnett Road, Dudley, West Midlands, DY1 2HQ, UK

    Antonios Stavropoulos-Kalinoglou, Giorgos S. Metsios, Vasileios F. Panoulas & George D. Kitas

  4. Department of Sport and Exercise Science, University of Thessaly, Trikala-Karyes Road, Trikala, 42100, Greece

    Athanasios Z. Jamurtas & Yiannis Koutedakis

  5. Institute of Human Performance and Rehabilitation, Trikala-Karyes Road, Trikala, 42100, Greece

    Athanasios Z. Jamurtas & Yiannis Koutedakis

  6. ARC Epidemiology Unit, University of Manchester, Oxford Road, Manchester, M13 9PT, UK

    George D. Kitas

Authors
  1. Antonios Stavropoulos-Kalinoglou
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  2. Giorgos S. Metsios
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  3. Vasileios F. Panoulas
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  4. Alan M. Nevill
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  5. Athanasios Z. Jamurtas
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  6. Yiannis Koutedakis
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  7. George D. Kitas
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Correspondence to Antonios Stavropoulos-Kalinoglou.

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Stavropoulos-Kalinoglou, A., Metsios, G.S., Panoulas, V.F. et al. Underweight and obese states both associate with worse disease activity and physical function in patients with established rheumatoid arthritis. Clin Rheumatol 28, 439–444 (2009). https://doi.org/10.1007/s10067-008-1073-z

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  • DOI: https://doi.org/10.1007/s10067-008-1073-z

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