A high body mass index is associated with reduced risk of rheumatoid arthritis in men, but not in women

Turesson, Carl; Bergström, Ulf; Pikwer, Mitra; Nilsson, Jan‐Åke; Jacobsson, Lennart

doi:10.1093/rheumatology/kev313

Cited by 34 publications

(43 citation statements)

References 32 publications

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“…In the present study we could not find support for a differentiated role for obesity according to the serologic status of RA, as some previous studies have indicated [7, 8, 15]. From this perspective we suggest that obesity, abdominal obesity and/or factors related to these, act as a trigger or drive on the inflammatory system(s), rather than exert a specific immunologic effect.…”

Section: Discussioncontrasting

confidence: 99%

“…In the present study the association between obesity and RA was seen mainly for early disease onset among men, and the Nurses’ Health Study included women exclusively, which makes the results difficult to compare [6]. Interestingly, our results contradict the results from a Swedish study in which high BMI in some regression models were associated with a reduced risk of RA in men, who compared with our study, were examined at a higher age [7]. If obesity acts as a strong trigger for disease onset at an early age in predisposed men, the selection of older age at examination could theoretically have contributed to an apparent protective effect.…”

Section: Discussioncontrasting

confidence: 79%

“…Negative associations with obesity have been reported in two studies: in RA [7] and ACPA-positive RA [15], respectively, in men. Another two studies reported no statistically significant associations between BMI or BMI categories and RA [13, 14].…”

Section: Introductionmentioning

confidence: 99%

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Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

Ljung

Rantapää‐Dahlqvist

2016

Arthritis Res Ther

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BackgroundThe risk of development of rheumatoid arthritis (RA) could be affected by immune activation in obesity. Our objective was to evaluate the association between obesity in general, and abdominal obesity, and the risk for subsequent development of RA.MethodsIn two large population-based, prospective cohorts, 557 cases (mean age at RA symptom onset 58, SD 10 years, 68% women) who subsequently developed RA and 1671 matched controls were identified. From a health examination antedating symptom onset (median 5.5 years), collected data on body mass index (BMI; kg/m2), smoking habits, and educational level was used in conditional logistical regression models. Corresponding regression models were used to analyse the association between waist circumference measurements (cm) and RA development in a subset of the population.ResultsBMI and waist circumference were associated with the risk of RA development, adjusted odds ratio (OR) (95% CI), 1.13 (1.00, 1.28) per 5 kg/m2, and 1.02 (1.01, 1.04) per cm, respectively. An association was also observed for obesity (BMI ≥30) OR 1.45 (1.07, 1.95), compared with BMI <25. After stratification for sex the associations were enhanced in men, and attenuated in women. Among men with BMI above normal a 3–5 times increased risk for RA disease development at 50 years of age or earlier was observed. Abdominal obesity with waist circumference >102 cm was associated with a 2–3 times increased risk of RA, but not abdominal obesity (>88 cm) in women.ConclusionsObesity or abdominal obesity, respectively, was independently associated with a modest increase of the risk for subsequent development of RA. This appeared to be relevant mainly for early RA disease onset among men.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-016-1171-2) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 79%

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Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

Ljung

Rantapää‐Dahlqvist

2016

Arthritis Res Ther

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“…Again, these results vary in recent studies. While some studies have shown similar results in men and women [12•, 22•], others have suggested that obesity may be associated with a decreased risk of RA among men [19••, 24]. Some studies have also shown an association between obesity and RA only in younger subgroups [12•, 20••], and it has been proposed that an effect specific to younger individuals might explain why no association between obesity and RA has been identified in some older cohorts [22•].…”

Section: Obesity and The Risk Of Developing Ramentioning

confidence: 96%

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

George

Baker

2016

Curr Rheumatol Rep

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With the prevalence of obesity increasing dramatically worldwide over the past several decades, an increasing body of literature has examined the impact of obesity in the context of rheumatoid arthritis (RA). Epidemiologic studies suggest that obesity may be associated with a modestly increased risk for the development of RA, although these studies have shown conflicting results. Among patients with established RA, obesity has been observed to be associated with greater subjective measures of disease activity and poor treatment response, but also with a decreased risk of joint damage and lower mortality. A comprehensive evaluation of the influence of obesity on the measurement of disease, response to therapies, and long-term prognosis is critical in order to understand these observations. This review therefore focuses on recent observations, potential explanations for these findings, and implications for clinicians and investigators caring for and studying patients with RA.

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“…In addition, the relationship between obesity and RA risk is conflicting. One study has shown that an increasing body mass index (BMI) was protective against RA development in men, although there was no significant relationship with RA risk in women (94). Another study showed that an increasing BMI was a risk factor for RA in both men and women, but less so in women (95).…”

Section: Environmental Risk Factors For Ramentioning

confidence: 99%

Genetic and environmental risk factors for rheumatoid arthritis

Deane

Demoruelle

Kelmenson

et al. 2017

Best Practice & Research Clinical Rheumatology

441

296

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Multiple genetic and environmental factors have been associated with an increased risk for rheumatoid arthritis (RA). Of these, the strongest associations have been seen with female sex, a family history of RA, the genetic factor the ‘shared epitope’ and with exposure to tobacco smoke. There is also renewed interest in mucosal inflammation and microbial factors as contributors to the development of RA. However, the identification of a ‘preclinical’ period of RA that can be defined as local or systemic autoimmunity as measured by autoantibodies and other biomarkers prior to the development of clinically-apparent synovitis suggests that the risk factors for RA are acting long prior to first clinical evidence of IA. As such, a major challenge to the field will be to investigate the full spectrum of the development of RA, from initiation and propagation of autoimmunity during preclinical RA and transition to clinically-apparent synovitis and classifiable RA, in order to determine which genetic and environmental factors are important at each stage of disease development. Understanding the exact role and timing of action of risk factors for RA is especially important given the advent of prevention trials in RA, and the hope that a full understanding of genetic and environmental factors in RA could lead to effective preventive interventions.

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A high body mass index is associated with reduced risk of rheumatoid arthritis in men, but not in women

Abstract: A high BMI was associated with a reduced risk of future RA in men, but not in women. Factors related to adipose tissue may contribute to mechanisms that are protective from RA in men.

Cited by 34 publications

References 32 publications

Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

Genetic and environmental risk factors for rheumatoid arthritis

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