Low body mass index is associated with impaired quality of life in patients with rheumatoid arthritis

Fukuda, Wataru; Omoto, Atsushi; Ohta, Tadashi; Majima, Susumu; Kimura, Toshihiro; Tanaka, Toru; Kohno, Masataka; Kawahito, Yutaka

doi:10.1111/1756-185x.12079

Cited by 23 publications

(14 citation statements)

References 21 publications

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“…Obesity represents an important link with comorbidities such as metabolic syndrome ( 71 ) and CV diseases ( 72 ); however, in some studies, increased BMI had the opposite effect of reduced mortality ( 70 , 73 ), which has been described as the “obesity paradox” ( 74 ). Moreover, in overweight RA patients, progression of bone destruction was reduced ( 75 , 76 ), the number of swollen joints is not increased, and better quality of life has been reported ( 77 ). Weight loss and cachexia represent major determinants for a greater risk of death ( 78 ) and worse quality of life ( 77 ), thus strengthening the paradoxical observation of lower mortality in obese patients.…”

Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

“…Moreover, in overweight RA patients, progression of bone destruction was reduced ( 75 , 76 ), the number of swollen joints is not increased, and better quality of life has been reported ( 77 ). Weight loss and cachexia represent major determinants for a greater risk of death ( 78 ) and worse quality of life ( 77 ), thus strengthening the paradoxical observation of lower mortality in obese patients. However, follow-up studies have demonstrated that in RA patients with a history of obesity reduced BMI is strongly associated with death.…”

Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

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Aging, Obesity, and Inflammatory Age-Related Diseases

2017

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The increase in the prevalence of obesity represents a worldwide phenomenon in all age groups and is pathologically and genetically correlated with several metabolic and cardiovascular diseases, representing the most frequent age-related diseases. Obesity superimposed on aging drastically increases chronic low-grade inflammation (inflammaging), which is an important link between obesity, insulin resistance, and age-associated diseases. Immune cells of both the innate and the adaptive immune systems infiltrate the adipose tissue (AT) and during obesity induce inflammatory responses associated with metabolic switches and changes in phenotypes and function of immune cell subsets. Obesity poses new health problems especially when it occurs in the context of other diseases, many of them frequently affect elderly subjects. An emerging problem is the decreased proportion of patients with obesity achieving clinical response to therapy. In this review, we will discuss the reciprocal influences of immune cell and AT inflammation in aging and age-associated diseases and the complex relationship of nutrient and energy-sensing homeostatic checkpoints, which contribute to shape the phenotype of the AT. We will specifically examine type-2 diabetes, rheumatoid arthritis, osteoarthritis, cognitive impairment, and dementia, where obesity plays a significant role, also in shaping some clinical aspects.

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Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

Aging, Obesity, and Inflammatory Age-Related Diseases

2017

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“…The sarcopenia of RC has been linked to the increased risk of osteoporosis, metabolic syndrome and cardiovascular disease observed in RA 5, 6 . Muscle loss in RA has also been associated with weakness, imbalance and a reduced quality of life, independent of inflammatory severity and duration 7 .…”

Section: Introductionmentioning

confidence: 99%

Compensatory anabolic signaling in the sarcopenia of experimental chronic arthritis

Little

Prieto-Potín

Pérez-Baos

et al. 2017

Sci Rep

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Inflammatory activity in rheumatoid arthritis may alter the regulation of muscle mass leading to a secondary sarcopenia, commonly termed rheumatoid cachexia (RC). We characterized alterations to muscle structure and various pro-inflammatory, catabolic and regenerative markers in an animal model of RC. Antigen induced arthritis (AiA) was performed in 20 male adult rabbits. AiA animals exhibited significantly less weight gain, a markedly elevated serum C-reactive protein (CRP), lighter muscles with shorter cross-sectional diameter and increased myonuclei when compared to controls. Atrogin-1 and MuRF-1 were up-regulated alongside an increase in IL-1β, active NF-κB and a higher ratio of phosphorylated to inactive p38 MAPK. CCL-2 and TNF levels were reduced and IL-6 was unchanged between groups. We observed decreased pSTAT3, unchanged pSTAT1 and Myf5, but increased Pax7, MyoD and myogenin. AiA rabbits had a reduction in myostatin from gastrocnemii and synovium with a congruent decrease in serum myostatin compared to controls. Chronic arthritis induced an RC-like secondary sarcopenia with increased muscle protein breakdown. Elevated IL-1β may trigger proteolysis via elevated NF-κB and p38 MAPK signaling with a compensatory anabolic response suggested by myonuclear expansion, increased Pax7, MyoD and myogenin, reduced pSTAT3 as well as reduced serum, synovial and muscular myostatin.

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“…In many other disease processes, wasting and/or low BMI are associated with poor QoL and decreased response to QoL interventions, so this was an unexpected finding [37–39]. Prior studies involving older HIV-infected adults have found a strong association between greater resilience and improved mental QoL [40].…”

Section: Discussionmentioning

confidence: 99%

Long-term impact of HIV wasting on physical function in the Multicenter AIDS Cohort Study

Erlandson

Abraham

et al. 2015

AIDS

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Background The long-term consequences of wasting among HIV-infected persons are not known. Design HIV-infected participants surviving ≥2 years based on Kaplan Meier analysis after a clinical diagnosis or weight trajectory consistent with wasting and with available physical function assessment data (grip strength, gait speed, and quality of life [QoL]) were matched to HIV-infected and -uninfected men without wasting. Methods Matching criteria at the functional assessment included age, calendar year, and CD4 cell count and plasma HIV-1 RNA (HIV-infected only). Multivariable linear regression analyses adjusted for age, cohort, race, hepatitis C status, and number of comorbid illnesses were used to assess the impact of wasting on subsequent physical function. Results Among 85 HIV-infected men surviving ≥2 years after wasting, we evaluated physical function outcomes compared to 249 HIV-infected and 338 HIV-uninfected men with no historical wasting. In multivariable regression models, HIV-infected men with prior wasting had lower grip strength and poorer physical QoL than HIV-infected men with no wasting (p≤0.03), and poorer physical QoL but higher mental QoL than HIV-uninfected men (p≤0.05). When controlling for measures of immune suppression (nadir CD4/AIDS, the association between wasting and physical QoL was markedly attenuated, whereas there was minimal impact on the association between wasting and grip strength. Conclusions HIV-infected wasting survivors had weaker grip strength compared to HIV-infected persons without wasting; immune suppression was associated only with physical QoL. HIV-infected survivors of wasting may represent a population of adults at increased risk for physical function decline.

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Low body mass index is associated with impaired quality of life in patients with rheumatoid arthritis

Abstract: Low BMI deteriorates the QOL of RA patients. Muscle protein loss apparently leads to a reduction in BMI and QOL.

Cited by 23 publications

References 21 publications

Aging, Obesity, and Inflammatory Age-Related Diseases

Aging, Obesity, and Inflammatory Age-Related Diseases

Compensatory anabolic signaling in the sarcopenia of experimental chronic arthritis

Long-term impact of HIV wasting on physical function in the Multicenter AIDS Cohort Study

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