High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

Abstract

Introduction: Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective: To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method: Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6-3.1; moderate 3.2-5.0; high > 5.1). Results: The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMIdefined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

“…Obesity is common among those who suffer from OA (51) and RA (52,53) . In the meta-analysis, one study (44) specifically recruited obese patients with knee OA, while another study's baseline characteristics indicate the inclusion of obese participants (42) .…”

Comorbidities in rheumatic diseases need special consideration during the COVID-19 pandemic

“…This can be closely associated with obesity. At least a quarter of RA patients are overweight (BMI > 25) [ 62 ]. Besides being a direct risk factor, it also contributes indirectly by increasing disease activity and making remission more difficult to achieve [ 99 ].…”

Interleukin-26 Has Synergistic Catabolic Effects with Palmitate in Human Articular Chondrocytes via the TLR4-ERK1/2-c-Jun Signaling Pathway

“…Inflammatory arthritis is associated with high serum and synovial fluid levels of IL-26, obesity, and disease activity [ 13 , 14 ]. This is the first report of the proinflammatory effects of IL-26 on articular cartilage and synergistic action with palmitate to promote the breakdown of the cartilage matrix.…”

“…A previous study reported that the saturated FFA palmitate (C16:0), but not monounsaturated oleate (C18:1), has synergistic catabolic effects with IL-1β in HACs [ 12 ]. High rates of obesity are also associated with disability of patients with rheumatoid arthritis and disease activity of ankylosing spondylitis [ 13 , 14 ]. However, the association of IL-26 and saturated FFAs in HACs has not been investigated.…”