Obesity, Weight Loss, and Progression of Disability in Rheumatoid Arthritis.
Obesity, Weight Loss, and Progression of Disability in Rheumatoid Arthritis.
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DOI：
10.1002/acr.23579
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发表时间：
2018-12
影响因子：
4.7
通讯作者：
Michaud K
中科院分区：
文献类型：
--
作者：
Baker JF;England BR;Mikuls TR;Sayles H;Cannon GW;Sauer BC;George MD;Caplan L;Michaud K
在横断面研究中，患有类风湿性关节炎（RA）的肥胖患者报告了更大的残疾。然而，肥胖的纵向影响并没有得到很好的表征。我们在两项大型登记研究中评估了肥胖、体重减轻和残疾恶化之间的相关性，并进行了长期随访。这项研究包括来自风湿性疾病国家数据库（Forward）（N= 23，323）和退伍军人事务部RA（VARA）登记研究（N= 1，697）的RA患者。在随访期间记录健康评估问卷（HAQ）或多维（MD）-HAQ的结果。显著恶化定义为HAQ或MD-HAQ增加>0.2。考克斯比例风险模型评估了相对于基线恶化的风险，调整了人口统计学、基线残疾、合并症、疾病持续时间和其他疾病特征。入组时，Forward [B：0.17（0.14，0.20）p<0.001]和VARA [B：0.17（0.074，0.27）p=0.001]中严重肥胖患者的残疾评分高于超重患者。在多变量模型中，在Forward [HR 1.25（1.18，1.33）p<0.001]和VARA [HR 1.33（1.07，1.66）p=0.01]中，与超重患者相比，入组时严重肥胖的患者发生进行性残疾的风险更大。在两个队列中，入组后体重减轻也与更大的风险相关。相关性独立于其他临床因素，包括时变CRP和VARA中肿胀关节计数。重度肥胖与RA残疾进展更快相关。体重减轻也与残疾恶化有关，可能是通过识别患有慢性疾病的个体以及与年龄相关或与疾病相关的虚弱的发展。
Obese patients with rheumatoid arthritis (RA) report greater disability in cross-sectional studies. The longitudinal effects of obesity, however, are not well-characterized. We evaluated associations between obesity, weight loss, and worsening of disability in two large registry studies with long-term follow-up. This study included patients with RA from the National Data Bank of Rheumatic Diseases (Forward) (N=23,323) and the Veterans Affairs RA (VARA) registry study (N=1,697). Results of the Health Assessment Questionnaire (HAQ) or Multi-Dimensional (MD)-HAQ were recorded over follow-up. Significant worsening was defined as an increase of HAQ or MD-HAQ of >0.2. Cox proportional hazards models evaluated the risk of worsening from baseline, adjusting for demographics, baseline disability, comorbidity, disease duration, and other disease features. At enrollment, disability scores were higher among severely obese patients compared to overweight in both Forward [B: 0.17 (0.14, 0.20) p<0.001] and VARA [B: 0.17 (0.074, 0.27) p=0.001]. In multivariable models, patients who were severely obese at enrollment had a greater risk of progressive disability compared to overweight patients in Forward [HR 1.25 (1.18, 1.33) p<0.001] and VARA [HR 1.33 (1.07, 1.66) p=0.01]. Weight loss following enrollment was also associated with a greater risk in both cohorts. Associations were independent of other clinical factors including time-varying CRP and swollen joint count in VARA. Severe obesity is associated with more rapid progression of disability in RA. Weight loss is also associated with worsening disability, possibly by identifying individuals with chronic illness and the development of age-related or disease-related frailty.
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影响因子：
4.7
作者：
Cannon GW;Mikuls TR;Hayden CL;Ying J;Curtis JR;Reimold AM;Caplan L;Kerr GS;Richards JS;Johnson DS;Sauer BC
通讯作者：
Sauer BC
影响因子：
4.7
作者：
Baker JF;Von Feldt J;Mostoufi-Moab S;Noaiseh G;Taratuta E;Kim W;Leonard MB
通讯作者：
Leonard MB
影响因子：
4.9
作者：
Mikuls TR;Gould KA;Bynoté KK;Yu F;Levan TD;Thiele GM;Michaud KD;O'Dell JR;Reimold AM;Hooker R;Caplan L;Johnson DS;Kerr G;Richards JS;Cannon GW;Criswell LA;Noble JA;Bridges SL Jr;Hughes L;Gregersen PK
通讯作者：
Gregersen PK
DOI：
10.1093/gerona/60.8.1007
发表时间：
2005-08-01
影响因子：
5.1
作者：
Lee, JS;Kritchevsky, SB;Newman, AB
通讯作者：
Newman, AB
影响因子：
4.7
作者：
Ajeganova, Sofia;Andersson, Maria L.;Hafstrom, Ingiald
通讯作者：
Hafstrom, Ingiald