Advertisement

Clinical Rheumatology

, Volume 33, Issue 4, pp 485–492 | Cite as

Lack association of body mass index with disease activity composites of rheumatoid arthritis in Korean population: cross-sectional observation

  • Jung-Yoon Choe
  • Jisuk Bae
  • Hwajeong Lee
  • Sung-Hoon Park
  • Seong-Kyu KimEmail author
Original Article

Abstract

The debate regarding the influence of body mass index (BMI) on clinical disease activity in rheumatoid arthritis (RA) remains unsolved. This study investigates whether BMI is associated with disease activity composites and clinical parameters in Korean patients with RA. A total of 568 patients with RA were consecutively enrolled in this study. BMI and disease activity composites including the Disease Activity Score 28 (DAS28) and the Clinical/Simplified Disease Activity Index (CDAI/SDAI) were assessed. Statistical analyses were performed using Chi-square, one-way ANOVA, and multivariate regression analyses. Remission of RA disease activity was defined as ≤2.6 in a DAS28 score. The mean BMI was 22.3 kg/m2 (SD 3.1). About 60.6 % (n = 344) of enrolled patients fell into the underweight and normal BMI categories. Swollen joint count was significantly different among the four BMI categories (p = 0.038). Multivariate regression analysis showed a negative correlation of BMI and erythrocyte sediment rate (ESR) in all patients (β= − 0.011, p = 0.049) and also found that other disease activity indices were not found to be associated with BMI. In patients with remission, lower BMI was associated with higher physician global estimate (β= − 0.446, p = 0.030). The negative association between BMI and ESR in the non-remission group was noted (β= − 0.016, p = 0.019). This study revealed lack association between BMI and disease activity composites of RA, although only ESR was found to be associated with BMI in RA patients.

Keywords

Body mass index Disease activity Erythrocyte sediment rate Rheumatoid arthritis 

Notes

Conflict of interest

The authors declare no competing interests.

Supplementary material

10067_2013_2427_MOESM1_ESM.doc (34 kb)
Supplement 1 Pearson’s correlation analysis for correlation between body mass index with selected clinical parameters (DOC 34 kb)

References

  1. 1.
    Gregersen PK, Silver J, Winchester RJ (1987) The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum 30:1205–1213PubMedCrossRefGoogle Scholar
  2. 2.
    Burmester GR, Yu DT, Irani AM, Kunkel HG, Winchester RJ (1981) Ia + T cells in synovial fluid and tissues of patients with rheumatoid arthritis. Arthritis Rheum 24:1370–1376PubMedCrossRefGoogle Scholar
  3. 3.
    Cottam DR, Mattar SG, Barinas-Mitchell E, Eid G, Kuller L, Kelley DE et al (2004) The chronic inflammatory hypothesis for the morbidity associated with morbid obesity: implications and effects of weight loss. Obes Surg 14:589–600PubMedCrossRefGoogle Scholar
  4. 4.
    Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372:425–432PubMedCrossRefGoogle Scholar
  5. 5.
    Sanna V, Di Giacomo A, La Cava A, Lechler RI, Fontana S, Zappacosta S et al (2003) Leptin surge precedes onset of autoimmune encephalomyelitis and correlates with development of pathogenic T cell responses. J Clin Invest 111:241–250PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Fraser DA, Thoen J, Reseland JE, Forre O, Kjeldsen-Kragh J (1999) Decreased CD4+ lymphocyte activation and increased interleukin-4 production in peripheral blood of rheumatoid arthritis patients after acute starvation. Clin Rheumatol 18:394–401PubMedCrossRefGoogle Scholar
  7. 7.
    Bokarewa M, Bokarew D, Hultgren O, Tarkowski A (2003) Leptin consumption in the inflamed joints of patients with rheumatoid arthritis. Ann Rheum Dis 62:952–956PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Symmons DP, Bankhead CR, Harrison BJ, Brennan P, Barrett EM, Scott DG et al (1997) Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: results from a primary care-based incident case–control study in Norfolk, England. Arthritis Rheum 40:1955–1961PubMedCrossRefGoogle Scholar
  9. 9.
    García-Poma A, Segami MI, Mora CS, Ugarte MF, Terrazas HN, Rhor EA et al (2007) Obesity is independently associated with impaired quality of life in patients with rheumatoid arthritis. Clin Rheumatol 26:1831–1835PubMedCrossRefGoogle Scholar
  10. 10.
    Klaasen R, Wijbrandts CA, Gerlag DM, Tak PP (2011) Body mass index and clinical response to infliximab in rheumatoid arthritis. Arthritis Rheum 63:359–364PubMedCrossRefGoogle Scholar
  11. 11.
    Gremese E, Carletto A, Padovan M, Atzeni F, Raffeiner B, Giardina AR et al (2013) Obesity and reduction of the response rate to anti-tumor necrosis factor α in rheumatoid arthritis: an approach to a personalized medicine. Arthritis Care Res 65:94–100CrossRefGoogle Scholar
  12. 12.
    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 30:2350–2355PubMedGoogle Scholar
  13. 13.
    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 67:769–774PubMedCrossRefGoogle Scholar
  14. 14.
    Westhoff G, Rau R, Zink A (2007) Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis Rheum 56:3575–3582PubMedCrossRefGoogle Scholar
  15. 15.
    Jawaheer D, Olsen J, Lahiff M, Forsberg S, Lähteenmäki J, da Silveira IG et al (2010) Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study. Clin Exp Rheumatol 28:454–461PubMedCentralPubMedGoogle Scholar
  16. 16.
    Caplan L, Davis LA, Bright CM, Kerr GS, Lazaro DM, Khan NA et al (2013) Body mass index and the rheumatoid arthritis swollen joint count: an observational study. Arthritis Care Res 65:101–106CrossRefGoogle Scholar
  17. 17.
    Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRefGoogle Scholar
  18. 18.
    Shiwaku K, Anuurad E, Enkhmaa B, Nogi A, Kitajima K, Shimono K et al (2004) Overweight Japanese with body mass indexes of 23.0–24.9 have higher risks for obesity-associated disorders: a comparison of Japanese and Mongolians. Int J Obes 28:152–158CrossRefGoogle Scholar
  19. 19.
    Steering Committee (2000) The Asia-Pacific perspective: redefining obesity and its treatment. International Diabetes Institute, MelbourneGoogle Scholar
  20. 20.
    Prevoo MLL, van't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LBA, van Riel PLCM (1995) Modified disease activity scores that include twenty-eight-joint counts: Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48PubMedCrossRefGoogle Scholar
  21. 21.
    Wells G, Becker JC, Teng J, Dougados M, Schiff M, Smolen J et al (2009) Validation of the 28-joint Disease Activity Score (DAS28) and European League Against Rheumatism response criteria based on C-reactive protein against disease progression in patients with rheumatoid arthritis, and comparison with the DAS28 based on erythrocyte sedimentation rate. Ann Rheum Dis 68:954–960PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Smolen JS, Breedveld FC, Schiff MH, Kalden JR, Emery P, Eberl G et al (2003) A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology (Oxford) 42:244–257CrossRefGoogle Scholar
  23. 23.
    Aletaha D, Nell VP, Stamm T, Uffmann M, Pflugbeil S, Machold K et al (2005) Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther 7:R796–R806PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    World Health Organisation (2000) Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. World Health Organ Tech Rep Ser 894:i–xii, 1–253Google Scholar
  25. 25.
    Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Kitas GD (2011) Obesity in rheumatoid arthritis. Rheumatology (Oxford) 50:450–462CrossRefGoogle Scholar
  26. 26.
    Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Nevill AM, Douglas KM, Jamurtas A et al (2007) Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis 66:1316–1321PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Sim KW, Lee SH, Lee HS (2001) The relationship between body mass index and morbidity in Korea. Korean J Obes 10:14–55Google Scholar
  28. 28.
    Innala L, Möller B, Ljung L, Magnusson S, Smedby T, Södergren A et al (2011) Cardiovascular events in early RA are a result of inflammatory burden and traditional risk factors: a five year prospective study. Arthritis Res Ther 13:R131PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Guin A, Chatterjee Adhikari M, Chakraborty S, Sinhamahapatra P, Ghosh A (2013) Effects of disease modifying anti-rheumatic drugs on subclinical atherosclerosis and endothelial dysfunction which has been detected in early rheumatoid arthritis: 1-year follow-up study. Semin Arthritis Rheum 43:48–54PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2013

Authors and Affiliations

  • Jung-Yoon Choe
    • 1
  • Jisuk Bae
    • 2
  • Hwajeong Lee
    • 1
  • Sung-Hoon Park
    • 1
  • Seong-Kyu Kim
    • 1
    Email author
  1. 1.Devision of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research CenterCatholic University of Daegu School of MedicineDaeguSouth Korea
  2. 2.Department of Preventive MedicineCatholic University of Daegu School of MedicineDaeguSouth Korea

Personalised recommendations