Clinical Rheumatology

, Volume 31, Issue 3, pp 479–482 | Cite as

Prevalence of overweight in Moroccan patients with rheumatoid arthritis and its relationships with disease features

  • Yousra Ibn YacoubEmail author
  • Bouchra Amine
  • Assia Laatiris
  • Fahd Wafki
  • Fatima Znat
  • Najia Hajjaj-Hassouni
Original Article


We aimed to estimate the prevalence of overweight in Moroccan patients with rheumatoid arthritis (RA) and its relationships with disease activity, functional disability, structural damage, and immunological status. Two hundred fifty patients with RA were consecutively included. Patients’ characteristics were specified. The following data were collected: age, disease duration, disease activity (evaluated with physical examination data, biological tests (erythrocyte sedimentation rate and C-reactive protein), and the disease activity score (DAS28)), radiographic changes (assessed by the Sharp’s method), functional disability (assessed by using the Health Assessment Questionnaire), extra-articular manifestations, immunological status, and treatment details. Overweight was defined according to the body mass index (BMI) values: underweight, <18.5; normal weight, 18.5–24.9; overweight, 25–29.9; and obesity, ≥30. The mean age of patients was 46.31 ± 12.64 years. The mean disease duration was 9.46 ± 8.43 years. Seventy-five patients (30%) were overweight, 42 (16.8%) were obese, and 133 (53.2%) were normal. Increased BMI was associated with the activity of disease (DAS28) (r = 0.426), structural damage (Sharp total score) (r = 0.297), the rate of rheumatoid factor (r = 0.311), and with the rate of anti-cyclic citrullinated protein antibodies (for all p ≤ 0.01). There were no statistically significant differences in BMI according to gender, dose and duration of corticosteroids, or functional impairment. In our sample, overweight seems to be prevalent in our RA patients. Overweight seems to occur independently of treatment and shown to be mainly associated to disease activity, structural damage, and immunological status. Large studies are needed to confirm those results.


Obesity Overweight Rheumatoid arthritis 





  1. 1.
    Van der Helm-van Mil AH, van der Kooij SM, Allaart CF, Toes RE, Huizinga TW (2008) A high body mass index has a protective effect on the amount of joint destruction in small joints in early rheumatoid arthritis. Ann Rheum Dis 67(6):769–774PubMedCrossRefGoogle Scholar
  2. 2.
    Duarte GV, Follador I, Cavalheiro CM, Silva TS, Oliveira Mde F (2010) Psoriasis and obesity: literature review and recommendations for management. An Bras Dermatol 85(3):355–360PubMedCrossRefGoogle Scholar
  3. 3.
    Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Nevill AM, Douglas KM, Jamurtas A, van Zanten JJ, Labib M, Kitas GD (2007) Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis 66(10):1316–1321PubMedCrossRefGoogle Scholar
  4. 4.
    Garcia-Poma A, Segami MI, Mora CS et al (2007) Obesity is independently associated with impaired quality of life in patients with rheumatoid arthritis. Clin Rheumatol 26:1831–1835PubMedCrossRefGoogle Scholar
  5. 5.
    Symmons DP (2002) Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol 16(5):707–722PubMedCrossRefGoogle Scholar
  6. 6.
    Sokka T, Toloza S, Cutolo M, Kautiainen H, Makinen H, Gogus F, Skakic V, Badsha H, Peets T, Baranauskaite A, Géher P, Ujfalussy I, Skopouli FN, Mavrommati M, Alten R, Pohl C, Sibilia J, Stancati A, Salaffi F, Romanowski W, Zarowny-Wierzbinska D, Henrohn D, Bresnihan B, Minnock P, Knudsen LS, Jacobs JW, Calvo-Alen J, Lazovskis J, Pinheiro Gda R, Karateev D, Andersone D, Rexhepi S, Yazici Y, Pincus T, QUEST-RA Group (2009) Women, men, and rheumatoid arthritis: analyses of disease activity, disease characteristics, and treatments in the QUEST-RA study. Arthritis Res Ther 11(1):R7PubMedGoogle Scholar
  7. 7.
    Giles JT, Bartlett SJ, Andersen R, Thompson R, Fontaine KR, Bathon JM (2008) Association of body fat with C-reactive protein in rheumatoid arthritis. Arthritis Rheum 58:2632–2641PubMedCrossRefGoogle Scholar
  8. 8.
    Jawaheer D, Olsen J, Lahiff M, Forsberg S, Lähteenmäki J, da Silveira LG, Rocha FA, Magalhães Laurindo IM, da Mota LM Henrique, Drosos AA, Murphy E, Sheehy C, Quirke E, Cutolo M, Rexhepi S, Dadoniene J, Verstappen SM, Sokka T, QUEST-RA (2010) Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA study. Clin Exp Rheumatol 28(4):454–461PubMedGoogle Scholar
  9. 9.
    Hippisley-Cox J, Coupland C, Robson J, Brindle P (2010) Derivation, validation, and evaluation of a new QRISK model to estimate lifetime risk of cardiovascular disease: cohort study using QResearch database. BMJ 341:c6624PubMedCrossRefGoogle Scholar
  10. 10.
    Elkan AC, Håkansson N, Frostegård J, Cederholm T, Hafström I (2009) Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 11(2):R37PubMedCrossRefGoogle Scholar
  11. 11.
    Van der Heijde DM, van Leeuwen MA, van Riel PL, van de Putte LB (1995) Radiographic progression on radiographs of hands and feet during the first 3 years of rheumatoid arthritis measured according to Sharp’s method (van der Heijde modification). J Rheumatol 22(9):1792–1796PubMedGoogle Scholar
  12. 12.
    Abourazzak FE, Benbouazza K, Amine B, Bahiri R, Lazrak N, Bzami F, Jroundi I, Abouqal R, Guillemin F, Hajjaj-Hassouni N (2008) Psychometric evaluation of a Moroccan version of health assessment questionnaire for use in Moroccan patients with rheumatoid arthritis. Rheumatol Int 28(12):1197–1203PubMedCrossRefGoogle Scholar
  13. 13.
    WHO (1995) Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 854, WHO, Geneva p. 452Google Scholar
  14. 14.
    Kaufmann J, Kielstein V, Kilian S, Stein G, Hein G (2003) Relation between body mass index and radiological progression in patients with rheumatoid arthritis. J Rheumatol 30(11):2350–2355PubMedGoogle Scholar
  15. 15.
    Westhoff G, Rau R, Zink A (2007) Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis Rheum 56(11):3575–3582PubMedCrossRefGoogle Scholar
  16. 16.
    Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF, Douglas KM, Nevill AM, Jamurtas AZ, Kita M, Koutedakis Y, Kitas GD (2008) Cigarette smoking associates with body weight and muscle mass of patients with rheumatoid arthritis: a cross-sectional, observational study. Arthritis Res Ther 10(3):R59PubMedCrossRefGoogle Scholar
  17. 17.
    Giles JT, Allison M, Bingham CO 3rd, Scott WM Jr, Bathon JM (2009) Adiponectin is a mediator of the inverse association of adiposity with radiographic damage in rheumatoid arthritis. Arthritis Rheum 61(9):1248–1256PubMedCrossRefGoogle Scholar
  18. 18.
    Hashimoto J, Garnero P, van der Heijde D, Miyasaka N, Yamamoto K, Kawai S, Takeuchi T, Yoshikawa H, Nishimoto N (2009) A combination of biochemical markers of cartilage and bone turnover, radiographic damage and body mass index to predict the progression of joint destruction in patients with rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs. Mod Rheumatol 19(3):273–282PubMedCrossRefGoogle Scholar
  19. 19.
    Fairchild AJ, MacKinnon DP (2009) A general model for testing mediation and moderation effects. Prev Sci 10(2):87–99PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2011

Authors and Affiliations

  • Yousra Ibn Yacoub
    • 1
    Email author
  • Bouchra Amine
    • 1
  • Assia Laatiris
    • 1
  • Fahd Wafki
    • 1
  • Fatima Znat
    • 1
  • Najia Hajjaj-Hassouni
    • 1
  1. 1.Department of Rheumatology (Pr N. Hajjaj-Hassouni), El Ayachi HospitalUniversity Hospital of Rabat-SaleSaleMorocco

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