Clinical Rheumatology

, Volume 38, Issue 2, pp 597–600 | Cite as

The impact of obesity on SLE disease activity: findings from the Southern California Lupus Registry (SCOLR)

  • Phildrich Teh
  • Bishoy Zakhary
  • Vaneet K. SandhuEmail author
Brief Report


The role of obesity in systemic lupus erythematosus (SLE) remains controversial. Studies have linked adiposity with a heightened risk of clinical complications including neurocognitive decline, renal impairment, dampened physical activity, and depressed quality of life—but not disease activity. We aimed to reexamine whether obesity in SLE patients independently associates with higher disease activity. Adult patients with SLE were recruited from the longitudinal, multi-ethnic Southern California Lupus Registry (SCOLR). Disease status was ascertained by calculating SLE Disease Activity Index (SLEDAI), which was then statistically analyzed for association with increased body mass index (BMI) by univariable and multivariable regression analyses. One hundred and thirty-seven patients were included in the study; 37% were obese (BMI ≥ 30 kg/m2). Obesity was significantly associated with SLEDAI (P = 0.026) and current steroid use (P = 0.029). Multivariable regression analysis demonstrated that obesity remained independently associated with lupus activity (OR 2.335, P = 0.026). In a representative sample of patients with SLE, obesity independently associated with worse SLE disease activity. Obesity may therefore be an important target for improving SLE outcomes.


Cardiovascular diseases Disease activity index Obesity Systemic lupus erythematosus 


Compliance with ethical standards

The institutional review board at Loma Linda University approved this study and all patients provided written informed consent for participation.




  1. 1.
    Agmon-levin N, Mosca M, Petri M, Shoenfeld Y (2012) Systemic lupus erythematosus one disease or many? Autoimmun Rev 11:593–595CrossRefGoogle Scholar
  2. 2.
    Bedoui S, Velkoska E, Bozinovski S, Jones JE, Anderson GP, Morris MJ (2005) Unaltered TNF-alpha production by macrophages and monocytes in diet-induced obesity in the rat. J Inflamm 2:2CrossRefGoogle Scholar
  3. 3.
    Versini M, Jeandel PY, Rosenthal E, Shoenfeld Y (2014) Obesity in autoimmune diseases: not a passive bystander. Autoimmun Rev 13:981–1000CrossRefGoogle Scholar
  4. 4.
    Amarilyo G, Iikuni N, Shi FD, Liu A, Matarese G, La Cava A (2013) Leptin promotes lupus T-cell autoimmunity. Clin Immunol 149:530–533CrossRefGoogle Scholar
  5. 5.
    Fujita Y, Fujii T, Mimori T, Sato T, Nakamura T, Iwao H, Nakajima A, Miki M, Sakai T, Kawanami T, Tanaka M, Masaki Y, Fukushima T, Okazaki T, Umehara H (2014) Deficient leptin signaling ameliorates systemic lupus erythematosus lesions in MRL/Mp-Fas lpr mice. J Immunol 192:979–984CrossRefGoogle Scholar
  6. 6.
    Yu Y, Liu Y, Shi FD, Zou H, Matarese G, La cava A (2013) Cutting edge: leptin-induced RORγt expression in CD4+ T cells promotes Th17 responses in systemic lupus erythematosus. J Immunol 190:3054–3058CrossRefGoogle Scholar
  7. 7.
    Liu Y, Yu Y, Matarese G, La cava A (2012) Cutting edge: fasting-induced hypoleptinemia expands functional regulatory T cells in systemic lupus erythematosus. J Immunol 188:2070–2073CrossRefGoogle Scholar
  8. 8.
    Rizk A, Gheita TA, Nassef S, Abdallah A (2012) The impact of obesity in systemic lupus erythematosus on disease parameters, quality of life, functional capacity and the risk of atherosclerosis. Int J Rheum Dis 15:261–267CrossRefGoogle Scholar
  9. 9.
    Chaiamnuay S, Bertoli AM, Roseman JM, McGwin G, Apte M, Duran S, Vila LM, Reveille JD, Alarcon GS (2007) African-American and Hispanic ethnicities, renal involvement and obesity predispose to hypertension in systemic lupus erythematosus: results from LUMINA, a multiethnic cohort (LUMINA XLV). Ann Rheum Dis 66:618–622CrossRefGoogle Scholar
  10. 10.
    Oeser A, Chung CP, Asanuma Y, Avalos I, Stein CM (2005) Obesity is an independent contributor to functional capacity and inflammation in systemic lupus erythematosus. Arthritis Rheum 52:3651–3659CrossRefGoogle Scholar
  11. 11.
    Katz P, Julian L, Tonner MC, Yazdany J, Trupin L, Yelin E, Criswell LA (2012) Physical activity, obesity, and cognitive impairment among women with systemic lupus erythematosus. Arthritis Care Res 64:502–510CrossRefGoogle Scholar
  12. 12.
    Katz P, Yazdany J, Julian L, Trupin L, Margaretten M, Yelin E, Criswell LA (2011) Impact of obesity on functioning among women with systemic lupus erythematosus. Arthritis Care Res 63:1357–1364CrossRefGoogle Scholar
  13. 13.
    Nikpour M, Urowitz MB, Gladman DD (2009) Epidemiology of atherosclerosis in systemic lupus erythematosus. Curr Rheumatol Rep 11:248–254CrossRefGoogle Scholar
  14. 14.
    Chung CP, Avalos I, Oeser A, Gebretsadik T, Shintani A, Raggi P, Stein CM (2007) High prevalence of the metabolic syndrome in patients with systemic lupus erythematosus: association with disease characteristics and cardiovascular risk factors. Ann Rheum Dis 66:208–214CrossRefGoogle Scholar
  15. 15.
    Chaiamnuay S, Bertoli AM, Fernández M, Apte M, Vila LM, Reveille JD et al (2007) The impact of increased body mass index on systemic lupus erythematosus: data from LUMINA, a multiethnic cohort (LUMINA XLVI) [corrected]. J Clin Rheumatol 13:128–133CrossRefGoogle Scholar
  16. 16.
    Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortlin PR et al (2012) Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 64:2677–2686CrossRefGoogle Scholar
  17. 17.
    Knight JS, Kaplan MJ (2013) Cardiovascular disease in lupus: insights and updates. Curr Opin Rheumatol 25:597–605CrossRefGoogle Scholar
  18. 18.
    Magder LS, Petri M (2012) Incidence of and risk factors for adverse cardiovascular events among patients with systemic lupus erythematosus. Am J Epidemiol 176:708–719CrossRefGoogle Scholar
  19. 19.
    Wang XY, Tang XQ, Huang YJ, Chen WY, Yu XQ (2012) Frequency of established cardiovascular disease and its risk factors in Chinese patients with systemic lupus erythematosus. Clin Rheumatol 31:669–675CrossRefGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  • Phildrich Teh
    • 1
  • Bishoy Zakhary
    • 2
  • Vaneet K. Sandhu
    • 3
    Email author
  1. 1.Department of Internal MedicineUniversity of California RiversideRiversideUSA
  2. 2.Office of ResearchRiverside University Health SystemMoreno ValleyUSA
  3. 3.Department of Internal Medicine, Division of RheumatologyLoma Linda UniversityLoma LindaUSA

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