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Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population

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Abstract

To determine if obesity is associated with poorer patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA), we conducted a cross-sectional study using data of the PRESPOND registry from a tertiary referral center in Singapore between 2011 and 2015. Demographics, clinical, and PRO variables were collected. Patients were divided into three categories: normal (BMI < 23 kg/m2), overweight (23 kg/m2 ≤ BMI < 27.5 kg/m2) and obese (BMI ≥ 27.5 kg/m2), using Asian BMI classification. The dependent variables are Pain score, Bath Ankylosing Spondylitis Patient Global Score (BAS-G), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Health Assessment Questionnaire (HAQ), and Medical Outcomes Study Short Form 36 version 2 (SF-36). Multivariate regression analyses were performed with these dependent variables and obesity categories, adjusting for confounders. Among 194 patients with axSpA, 32% are overweight while 22% are obese. We found that obese patients had significant poorer pain (β: 11.87, 95%CI 2.13, 21.60) and BAS-G scores (β: 10.18, 95%CI 1.59, 18.76) when compared to normal BMI patients. However, obesity was not associated with BASDAI (β 0.50, 95%CI -0.22, 1.22), BASFI (β 0.08, 95%CI -0.66, 0.81), HAQ (β -0.07, 95%CI -0.21, 0.06), physical component summary (β -0.02, 95%CI -4.47, 4.44), and mental component summary (β -2.85, 95%CI -7.57, 1.88) of SF-36. Obesity was associated with pain score and BAS-G but not with BASDAI, BASFI, HAQ, and SF-36. Further study is needed to examine the causal relationship between obesity and poorer PROs.

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Authors and Affiliations

  1. Department of Pharmacy, National University of Singapore, Singapore, Singapore

    Yi Xuan Lee, Wan Yu Png & Eng Hui Chew

  2. Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore

    Yu Heng Kwan, Ka Keat Lim, Julian Thumboo & Truls Østbye

  3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Chuen Seng Tan

  4. Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore

    Nai Lee Lui, Julian Thumboo & Warren Fong

  5. Duke-NUS Medical School, Singapore, Singapore

    Warren Fong

  6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Warren Fong

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  1. Yi Xuan Lee
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  2. Yu Heng Kwan
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  3. Wan Yu Png
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  4. Ka Keat Lim
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  5. Chuen Seng Tan
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Correspondence to Warren Fong.

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Yi Xuan Lee and Yu Heng Kwan contributed equally to this work.

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Lee, Y.X., Kwan, Y.H., Png, W.Y. et al. Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population. Clin Rheumatol 36, 2365–2370 (2017). https://doi.org/10.1007/s10067-017-3585-x

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  • DOI: https://doi.org/10.1007/s10067-017-3585-x

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