Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data
Journal Title: International Journal of Clinical Rheumatology - Year 2018, Vol 13, Issue 1
Abstract
Background: 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.
Authors and Affiliations
David J. Kreps, Florencia Halperin, Sonali P. Desai, Zhi Z. Zhang, Elena Losina, Amber T. Olson, Elizabeth W. Karlson, Bonnie L. Bermas, Jeffrey A. Sparks
Keywords
Related Articles
- EP ID EP603802
- DOI -
- Views 41
- Downloads 0
Ethnicity in rheumatic disease
Definition of ethnicity varies depending on the context, precise purposes of clinical practice, census, national surveillance of vital and health statistics, etc. It defines particular groups on the basis of language in...
Gender differences in ankylosing spondylitis patients: Relation to clinical characteristics, functional status and disease activity
Objective: To assess gender differences in Ankylosing Spondylitis (AS) patients regarding the clinical presentation, disease activity and functional status. Methods and findings: Forty AS patients; 21 males and 19 femal...
Ambulatory blood pressure monitoring and hypertension related cardiovascular risk in patients with rheumatoid arthritis
Background: To assess hypertension related cardiovascular risk parameters in patients with rheumatoid arthritis. To determine the effect of long-term treatment with corticosteroids, non-steroid antiinflammatory drugs, an...
The role of miRNAs in autoimmune inflammatory diseases
MicroRNAs (miRNAs) are abundant short 21- 23 nucleotides-long non-coding RNAs that modulate virtually all eukaryotic gene expression processes during development and are crucial for sustaining optimal cell functions and...
25-hydroxyvitamin D3 deficiency and vitamin D receptor polymorphisms in Egyptian patients with Behçet’s disease: a pilot study
Background: We investigated serum levels of 25-hydroxyvitamin D3 and the vitamin D receptor (VDR) gene polymorphisms (Fokl, Bsml) in Egyptian patients with Behçet’s disease (BD) and their relationship to disease manifest...