Clinical Rheumatology

, Volume 28, Issue 4, pp 439–444 | Cite as

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

  • Antonios Stavropoulos-KalinoglouEmail author
  • Giorgos S. Metsios
  • Vasileios F. Panoulas
  • Alan M. Nevill
  • Athanasios Z. Jamurtas
  • Yiannis Koutedakis
  • George D. Kitas
Original Article


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.


Body weight Body mass index Obesity Percentage body fat Rheumatoid arthritis outcome 



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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Copyright information

© Clinical Rheumatology 2008

Authors and Affiliations

  • Antonios Stavropoulos-Kalinoglou
    • 1
    • 2
    • 3
    Email author
  • Giorgos S. Metsios
    • 1
    • 2
    • 3
  • Vasileios F. Panoulas
    • 3
  • Alan M. Nevill
    • 1
    • 2
  • Athanasios Z. Jamurtas
    • 4
    • 5
  • Yiannis Koutedakis
    • 1
    • 4
    • 5
  • George D. Kitas
    • 2
    • 3
    • 6
  1. 1.School of Sport, Performing Arts and LeisureWolverhampton UniversityWalsallUK
  2. 2.Research Institute in Healthcare ScienceUniversity of WolverhamptonWolverhamptonUK
  3. 3.Department of RheumatologyDudley Group of Hospitals NHS Trust, Russells Hall HospitalDudleyUK
  4. 4.Department of Sport and Exercise ScienceUniversity of ThessalyTrikalaGreece
  5. 5.Institute of Human Performance and RehabilitationTrikalaGreece
  6. 6.ARC Epidemiology UnitUniversity of ManchesterManchesterUK

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