Prevalence of overweight and obesity, and associated risk factors in an axial spondyloarthritis cohort

Abstract

Background. Overweight and obesity are more common in axial spondyloarthritis (axSpA) cohorts than in the general population. The purpose of this study wase to assess the prevalence of overweight in patients with axSpA depending on sex and to identify axSpA-related factors, which are positively associated with body weight (BW). Materials and methods. Study design: a retrospective single-institution case series. Data source: medical records of patients with axSpA. Nutritional status was categorized by body mass index (BMI) according to WHO criteria. Results. The data of 142 patients with axSpA (78.2 % men) were analyzed. Weight was positively associated with: height (p < 0.0001), BASMI ≥ 4 (p < 0.0001), methotrexate treatment (p < 0.000) and cumulative glucocorticoids (GCs) dose ≥ 1.45 g (p = 0.01), with the relative importance (RI) of each factor of 100, 59, 61, and 24.8 %. The strength of the association between BW and BASMI was attenuated under the influence of the following confounders: gender (23.7 %), age (20.7 %), height (12.9 %) and strengthened under by the influence of BASDAI ≥ 7 (by 13.7 %) and the duration of GCs therapy (by 11.1 %). Height was negatively associated with female gender (p < 0.0001) and back pain intensity (p < 0.04). The developed regression models for body weight and height explained, respectively, 57.8 and 54 % of the variations parameters of patients with axSpA. Conclusions. Prevalence of overweight in the study sample of Ukrainian axSpA patients is lower than in cohorts outside of Ukraine, but still significant positive association of BW with spinal mobility limitation, exposure to MTX and high cumulative dose of GCs provides preliminary evidence their role in pathological weight gain.