Effects of obesity on health-related quality of life in juvenile-onset systemic lupus erythematosus

Abstract

Objective Evaluate the effects of obesity on health-related quality of life (HRQOL) measures in juvenile-onset SLE (jSLE). Methods Obesity was defined as a body mass index (BMI) ≥ 95th% according to the sex-specific Center for Disease Control body mass index-for-age charts and determined in a multicenter cohort of jSLE patients. In this secondary analysis, the domain and summary scores of the Pediatric Quality of Life (PedsQL) Inventory and the Child Health Questionnaire (CHQ) of obese jSLE patients were compared to those of non-obese jSLE patients as well as historical obese and non-obese healthy controls. Mixed-effects modeling was performed to evaluate the relationship between obesity and HRQOL measures. Results Among the 202 jSLE patients, 25% (n=51) were obese. Obesity had a significant negative impact on HRQOL in jSLE, even after adjusting for differences in current corticosteroid use, disease activity, disease damage, gender, and race between groups. Obese jSLE patients had lower physical functioning compared to non-obese jSLE patients, and to non-obese and obese healthy controls. Compared to their non-obese counterparts, obese jSLE patients also had worse school functioning, more pain, worse social functioning, and emotional functioning. Parents of obese jSLE patients worry more. The CHQ scores for obese jSLE patients were also worse compared to non-obese jSLE patients in several other domains Conclusion Our study demonstrates the detrimental effects of obesity on patient-reported outcomes in jSLE. This supports the importance of weight management for the therapeutic plan of jSLE.

Long‐Term Clinical Outcomes in a Cohort of Adults With Childhood‐Onset Systemic Lupus Erythematosus

“…Interestingly, an even larger negative effect was seen with regard to factors affecting physical appearance. Indeed, 2 other studies showed that changes in physical appearance (e.g., obesity, skin involvement) were associated with reduced HRQoL . Surprisingly, in the CHILL‐NL cohort, the presence of damage barely affected HRQoL, with only scores in the physical functioning domain significantly reduced.…”

Health‐Related Quality of Life Measures in Childhood‐Onset Systemic Lupus Erythematosus

“…This measure has not been used as an outcome measure in clinical trials, but it has been used as an outcome measure in a number of observational studies (6,42–44). For example, a study of 98 children with cSLE demonstrated significantly lower HRQoL in children with cSLE compared with normative cohorts, including a mean CHQ PhS of 49 (SD 7) and a mean CHQ PsS of 42 (SD 12) (5).…”

Obesidad, adipoquinas y lupus eritematoso sistémico

“…No obstante, diversos factores medioambientales como la exposición a tóxicos, a fármacos, el tabaquismo y factores hormonales entre otros han sido ampliamente investigados y relacionados con el LES, por lo que no es de extrañar que la obesidad tenga también un papel en la patogénesis del LES. Donde sí parece existir evidencia es en la relación que existe entre la obesidad y peores índices de funcionalidad y calidad de vida en pacientes con LES [41,42] .…”