Obesity Increases Disease Activity of Norwegian Patients with Axial Spondyloarthritis: Results from the European Map of Axial Spondyloarthritis Survey

Abstract

Objective To investigate the prevalence of overweight and obesity, as well as the association between body mass index (BMI) and disease activity in patients with axial spondyloarthritis (axSpA). Methods Norwegian axSpA patients from the European Map of Axial Spondyloarthritis (EMAS) survey were included in this analysis. Sociodemographic, anthropomorphic, and disease-related variables (HLA-B27, comorbidities, BASDAI, and selfreported spinal stiffness) were reported. Patients were categorized into under/normal weight (BMI < 25 kg/m 2), overweight (BMI ≥ 25 to < 30 kg/m 2), and obese (≥ 30 kg/m 2). Results Of the 509 participants in the EMAS survey, 35% were categorized as under/normal weight, 39% overweight, and 26% obese. Compared to under/normal-weight patients, overweight patients had significantly higher degree of spinal stiffness (mean (SD) 7.91 ± 2.02 vs 7.48 (2.15) and number of comorbidities (2.45 ± 2.11, vs 1.94), both p < 0.001. Obese patients had significantly higher disease activity (BASDAI mean (SD) 5.87 ± 1.78 vs 4.99 ± 2.08, p < 0.001), degree of spinal stiffness (8.18 ± 2.03 vs 7.48 ± 2.15, p = 0.006), and number of comorbidities (3.43 ± 2.43 vs 1.94. ± .38, p < 0.001) than under/normal weight patients. After adjusting for gender and age, obesity proved to be independently associated with disease activity. Conclusion Obesity was associated with higher reported BASDAI score, and being overweight or obese was associated with a higher degree of spinal stiffness and number of comorbidities compared to under/normal weight respondents. The results highlight the serious impact of obesity on health status, and obesity should therefore be considered as a modifiable risk factor for disease activity within the disease management of axSpA.

Reviewing Disease Activity Indices in Spondyloarthritis From the Sex Perspective: A Systematic Review and Metaanalysis

“…Nearly all the studies (n = 38, 92.7%) were published in or after 2010, with 26 of them (63.4%) in or after 2015. According to the study design, 31 studies (75.6%) were cross-sectional, 14,24,[27][28][29][31][32][33][34][35][36][37][38]40,41,[44][45][46][47][48][49][53][54][55][56][57][58][59][60][61][62] 9 studies (22.0%) were cohort studies, 15,25,30,39,42,43,[50][51][52] and 1 was a case-control study. 26 Twenty-five studies (61.0%) included patients with AS, 15,25,26,[30][31][32][33][36][37]…”

Anatomical Joint Form Variation in Sacroiliac Joint Disease: Current Concepts and New Perspectives

“…Ward et al showed that physically demanding occupations were associated with more functional limitations than sedentary ones [ 15 ]. Recent clinical studies by Bindesboll et al [ 16 ] and Bakirci et al [ 17 ] found more spinal stiffness, more new bone formation, and higher BASDAI scores in obese axSpA patients and attributed these at least in part to the increased axial load in overweight individuals.…”

Obesity, Lipid Profile and Cytokines in Spondyloarthritis

“…The mechanism explaining how obesity influences disease activity is not clear. [ 12 ] It can be due to the high secretion of pro-inflammatory cytokines. Indeed, IL-8 and IL-22 levels were significantly higher in patients with obesity and abdominal obesity.…”