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Research ArticleArticle

Association of Body Mass Index Categories with Disease Activity and Radiographic Joint Damage in Rheumatoid Arthritis: A Systematic Review and Metaanalysis

Celine Vidal, Thomas Barnetche, Jacques Morel, Bernard Combe and Claire Daïen
The Journal of Rheumatology December 2015, 42 (12) 2261-2269; DOI: https://doi.org/10.3899/jrheum.150224
Celine Vidal
From the Rheumatology Department, Hôpital Lapeyronie, Montpellier I University; Institut of Molecular Genetic of Montpellier, Unité Mixte de Recherche n. 5535 (UMR5535), Montpellier; Rheumatology Department, Hôpital Pellegrin, Bordeaux, France.
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Thomas Barnetche
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Jacques Morel
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Bernard Combe
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Claire Daïen
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  • For correspondence: c-daien@chu-montpellier.fr
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Abstract

Objective. Obesity and overweight are increasing conditions. Adipose tissue with proinflammatory properties could be involved in rheumatoid arthritis (RA) activity and radiographic progression. This study aims to investigate the influence of overweight and obesity on RA activity and severity.

Methods. We conducted a systematic review and metaanalysis to assess the association of body mass index (BMI) categories with the Disease Activity Score in 28 joints (DAS28), functional disability [Health Assessment Questionnaire (HAQ)], and radiographic joint damage in patients with RA. We searched Medline through PubMed, EMBASE, and the Cochrane Database of Systematic Reviews for all studies assessing DAS28, HAQ, or/and radiographic damage according to predefined BMI groups.

Results. Among the 737 citations retrieved, 58 articles met the inclusion criteria and 7 were included in the metaanalysis. DAS28 was higher in obese (BMI > 30 kg/m2) than non-obese (BMI ≤ 30 kg/m2) patients (mean difference 0.14, 95% CI 0.01–0.27, p = 0.04, I2 = 0%). HAQ score was also higher among obese patients (mean difference 0.10, 95% CI 0.01–0.19, p = 0.03, I2 = 0%). Radiographic joint damage was negatively associated with obesity (standardized mean difference −0.15, 95% CI −0.29 to −0.02, p = 0.03, I2 = 38%).

Conclusion. Obesity in RA is associated with increased DAS28 and HAQ score and with lower radiographic joint damage. These associations mainly result from an increase of subjective components of the DAS28 (total joint count and global health assessment) in obese patients. Conflicting results were reported concerning inflammation markers (C-reactive protein and erythrocyte sedimentation rate).

Key Indexing Terms:
  • RHEUMATOID ARTHRITIS
  • OBESITY
  • BODY MASS INDEX
  • Accepted for publication August 13, 2015.
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The Journal of Rheumatology
Vol. 42, Issue 12
1 Dec 2015
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Association of Body Mass Index Categories with Disease Activity and Radiographic Joint Damage in Rheumatoid Arthritis: A Systematic Review and Metaanalysis
Celine Vidal, Thomas Barnetche, Jacques Morel, Bernard Combe, Claire Daïen
The Journal of Rheumatology Dec 2015, 42 (12) 2261-2269; DOI: 10.3899/jrheum.150224

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Association of Body Mass Index Categories with Disease Activity and Radiographic Joint Damage in Rheumatoid Arthritis: A Systematic Review and Metaanalysis
Celine Vidal, Thomas Barnetche, Jacques Morel, Bernard Combe, Claire Daïen
The Journal of Rheumatology Dec 2015, 42 (12) 2261-2269; DOI: 10.3899/jrheum.150224
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Keywords

RHEUMATOID ARTHRITIS
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BODY MASS INDEX

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  • OBESITY
  • BODY MASS INDEX

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