RT Journal Article
SR Electronic
T1 Abdominal Obesity in Comparison with General Obesity and Risk of Developing Rheumatoid Arthritis in Women
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.200056
DO 10.3899/jrheum.200056
A1 Nathalie E.  Marchand
A1 Jeffrey A.  Sparks
A1 Sara K.  Tedeschi
A1 Susan Malspeis
A1 Karen H.  Costenbader
A1 Elizabeth W.  Karlson
A1 Bing Lu
YR 2020
UL http://www.jrheum.org/content/early/2020/07/09/jrheum.200056.abstract
AB Objective Being overweight or obese increases rheumatoid arthritis (RA) risk among women, particularly among those diagnosed at younger age. Abdominal obesity may contribute to systemic inflammation more than general obesity, thus we investigated whether abdominal obesity, compared with general obesity, predicted RA risk in 2 prospective cohorts, the Nurses’ Health Study (NHS) and NHS II. Methods We followed 50,682 women (1986-2014) in NHS and 47,597 women (1993-2015) in NHS II, without RA at baseline. Waist circumference (WC), body mass index (BMI), health outcomes and covariate data were collected through biennial questionnaires. Incident RA cases and serologic status were identified by chart review. We examined the associations of WC and BMI with RA risk using time-varying Cox proportional hazards models. We repeated analyses restricted to age ≤55 years. Results During 28 years of follow-up, we identified 844 incident RA cases (527 NHS, 317 NHS II). Women with WC >35 inches (88 cm) had increased RA risk (HR 1.22, 95% CI 1.06-1.41). A similar association was observed for seropositive RA, which was stronger among young and middle-aged women. Further adjustment for BMI attenuated the association to null. In contrast, BMI was associated with RA (HRBMI ≥30vs<25 1.33, 95% CI 1.05-1.68) and seropositive RA, even after adjusting for WC, and, as in WC analyses, this association was stronger among young and middle-aged women. Conclusion Abdominal obesity was associated with increased RA risk, particularly for seropositive RA, among young and middle-aged women, however, it did not independently contribute to RA risk beyond general obesity.