Body mass index and the risk of rheumatoid arthritis: a systematic review and dose-response meta-analysis

Qin, Bao‐Dong; Yang, Min; Fu, Hua; Ma, Ning; Wei, Tingting; Tang, Qingqin; Hu, Zhide; Liang, Yan; Yang, Zaixing; Zhong, Renqian

doi:10.1186/s13075-015-0601-x

Cited by 193 publications

(169 citation statements)

References 41 publications

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“…Among these large studies, obesity was not consistently associated with a significantly increased risk of incident RA in the population overall, and when present, the association was relatively modest, with HR ranging between 1.0 and 1.49 (Table 1) [12•, 19••, 20••, 21, 22•]. A recent meta-analysis of 11 studies, including 5 recent studies, did find a significant association between obesity and RA with a relative risk 1.31 (95 % CI 1.12 to 1.53), although because there was significant heterogeneity between studies, calculating a pooled relative risk is potentially problematic [23]. …”

Section: Obesity and The Risk Of Developing Ramentioning

confidence: 99%

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

George

Baker

2016

Curr Rheumatol Rep

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With the prevalence of obesity increasing dramatically worldwide over the past several decades, an increasing body of literature has examined the impact of obesity in the context of rheumatoid arthritis (RA). Epidemiologic studies suggest that obesity may be associated with a modestly increased risk for the development of RA, although these studies have shown conflicting results. Among patients with established RA, obesity has been observed to be associated with greater subjective measures of disease activity and poor treatment response, but also with a decreased risk of joint damage and lower mortality. A comprehensive evaluation of the influence of obesity on the measurement of disease, response to therapies, and long-term prognosis is critical in order to understand these observations. This review therefore focuses on recent observations, potential explanations for these findings, and implications for clinicians and investigators caring for and studying patients with RA.

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Section: Obesity and The Risk Of Developing Ramentioning

confidence: 99%

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

George

Baker

2016

Curr Rheumatol Rep

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“…Obesity increases the risk of developing chronic diseases such as hypertension, diabetes mellitus, coronary heart disease, and rheumatoid arthritis (RA) (3, 4). …”

Section: Introductionmentioning

confidence: 99%

Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data

Kreps¹,

Halperin²,

Desai³

et al. 2018

ISSN 1758-4272 Int. J. Clin. Rheumatol

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Objective To evaluate the association between weight loss and rheumatoid arthritis (RA) disease activity. Methods We conducted a retrospective cohort study of RA patients seen at routine clinic visits at an academic medical center, 2012–2015. We included patients who had ≥2 clinical disease activity index (CDAI) measures. We identified visits during follow-up where the maximum and minimum weights occurred and defined weight change and CDAI change as the differences of these measures at these visits. We defined disease activity improvement as CDAI decrease of ≥5 and clinically relevant weight loss as ≥5 kg. We performed logistic regression analyses to establish the association between improved disease activity and weight loss and baseline BMI category (≥25 kg/m2 or <25 kg/m2). We built linear regression models to investigate the association between continuous weight loss and CDAI change among patients who were overweight/obese at baseline and who lost weight during follow-up. Results We analyzed data from 174 RA patients with a median follow-up of 1.9 years (IQR 1.3–2.4); 117 (67%) were overweight/obese at baseline, and 53 (31%) lost ≥5 kg during follow-up. Patients who were overweight/obese and lost ≥5 kg had three-fold increased odds of disease activity improvement compared to those who did not (OR 3.03, 95%CI 1.18–7.83). Among those who were overweight/obese at baseline, each kilogram weight loss was associated with CDAI improvement of 1.15 (95%CI 0.42–1.88). Our study was limited by using clinical data from a single center without fixed intervals for assessments. Conclusion Clinically relevant weight loss (≥5 kg) was associated with improved RA disease activity in the routine clinical setting. Further studies are needed for replication and to evaluate the effect of prospective weight loss interventions on RA disease activity.

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“…Another two studies reported no statistically significant associations between BMI or BMI categories and RA [13, 14]. The comparison between studies is hampered by differences in methodology, but a recent meta-analysis suggested a 30% increase in the risk of RA overall in obesity compared with normal weight [17]. …”

Section: Introductionmentioning

confidence: 99%

Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

Ljung

Rantapää‐Dahlqvist

2016

Arthritis Res Ther

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BackgroundThe risk of development of rheumatoid arthritis (RA) could be affected by immune activation in obesity. Our objective was to evaluate the association between obesity in general, and abdominal obesity, and the risk for subsequent development of RA.MethodsIn two large population-based, prospective cohorts, 557 cases (mean age at RA symptom onset 58, SD 10 years, 68% women) who subsequently developed RA and 1671 matched controls were identified. From a health examination antedating symptom onset (median 5.5 years), collected data on body mass index (BMI; kg/m2), smoking habits, and educational level was used in conditional logistical regression models. Corresponding regression models were used to analyse the association between waist circumference measurements (cm) and RA development in a subset of the population.ResultsBMI and waist circumference were associated with the risk of RA development, adjusted odds ratio (OR) (95% CI), 1.13 (1.00, 1.28) per 5 kg/m2, and 1.02 (1.01, 1.04) per cm, respectively. An association was also observed for obesity (BMI ≥30) OR 1.45 (1.07, 1.95), compared with BMI <25. After stratification for sex the associations were enhanced in men, and attenuated in women. Among men with BMI above normal a 3–5 times increased risk for RA disease development at 50 years of age or earlier was observed. Abdominal obesity with waist circumference >102 cm was associated with a 2–3 times increased risk of RA, but not abdominal obesity (>88 cm) in women.ConclusionsObesity or abdominal obesity, respectively, was independently associated with a modest increase of the risk for subsequent development of RA. This appeared to be relevant mainly for early RA disease onset among men.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-016-1171-2) contains supplementary material, which is available to authorized users.

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Body mass index and the risk of rheumatoid arthritis: a systematic review and dose-response meta-analysis

Cited by 193 publications

References 41 publications

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

The Obesity Epidemic and Consequences for Rheumatoid Arthritis Care

Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data

Abdominal obesity, gender and the risk of rheumatoid arthritis – a nested case–control study

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