Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies

Abstract

Several studies have investigated associations between overweight/obesity and risk of developing rheumatoid arthritis, however, the evidence is not entirely consistent, and previous meta-analyses mainly included case–control studies, which can be affected by various biases. We therefore conducted a systematic review and meta-analysis of cohort studies on adiposity and risk of rheumatoid arthritis. Relevant studies were identified by searching PubMed and Embase databases. Random effects models were used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for rheumatoid arthritis in relation to different measures of adiposity. Thirteen cohort studies (10 publications) were included. The summary RR per 5 kg/m2 increase in body mass index (BMI) was 1.11 (95% CI 1.05–1.18, I2 = 50%), but the association was restricted to women (1.15, 95% CI 1.08–1.21, I2 = 17%) and not observed in men (0.89, 95% CI 0.73–1.09, I2 = 58%). The summary RR per 5 kg/m2 increment in BMI at age 18 years was 1.17 (95% CI 1.01–1.36, I2 = 26%, n = 3), and per 10 cm increase in waist circumference was 1.13 (95% CI 1.02–1.25, I2 = 44%, n = 2). Higher BMI in middle age, BMI at age 18 years, and waist circumference were associated with increased rheumatoid arthritis risk, suggesting adiposity could be targeted for primary prevention.

Bardet–Biedl Syndrome ciliopathy is linked to altered hematopoiesis and dysregulated self‐tolerance

“…Indeed, we have shown elevated prevalence of autoimmune disorders (namely T1DM, inflammatory bowel diseases, rheumatoid arthritis, and hypothyroidism) in two independent BBS cohorts. Obesity potentially contributes to the increased prevalence of autoimmune diseases in BBS patients, as obesity is associated with high prevalence of hypothyroidism, Hashimoto's thyroiditis, and rheumatoid arthritis (Song et al , 2019; Ohno et al , 2020). We also observed alteration of the white blood cell count in BBS patients and in a BBS mouse model.…”

Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis

“…Another study also demonstrated that even being overweight (BMI>25) increased risk of RA, especially in adults less than 50 years of age [ 26 ]. Others have suggested the association between increased BMI and RA is greatest for women [ 27 – 29 ] or smokers [ 29 ].…”

“…Factors related to obesity may also increase risk of RA. A more recent meta-analysis showed not only BMI but also increased weight circumference increased risk of RA [ 27 ]. Along similar lines, a large cohort study within the Nurse’s Health Study showed that physical activity dramatically reduced the risk of later developing RA, with BMI mediating only 14% of this effect [ 30 •].…”

CCR2/CCL2 and CMKLR1/RvE1 chemokines system levels are associated with insulin resistance in rheumatoid arthritis

“…Supported by previous studies, we know a high BMI is linked to increased disease activity and disability at disease onset, being an independent factor of less responsive to therapy [ 42 , 43 ]. However, not all studies led to a common conclusion, and some of them gave inconsistent results [ 44 ].…”

“…Previous studies reported that these different adipose tissue depots showed metabolic implications and effects [ 45 ]. The former has been more commonly linked to hypertension and T2D, while the latter conferred a neutral or even protective effect against metabolic disease [ 44 ].…”