Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis.
Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis.
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体重对风湿性疾病患者最小疾病活性的影响：系统评价和荟萃分析。
DOI：
10.1186/s13075-016-1194-8
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发表时间：
2016-12-13
影响因子：
4.9
通讯作者：
Di Minno MN
中科院分区：
文献类型：
--
作者：
Lupoli R;Pizzicato P;Scalera A;Ambrosino P;Amato M;Peluso R;Di Minno MN
在这项研究中，我们评估了肥胖和/或超重对银屑病关节炎（PsA）患者和类风湿关节炎（RA）患者接受抗风湿病治疗实现最小疾病活动度（MDA）的影响。肥胖可以被认为是一种低度的慢性全身性炎症性疾病，一些研究表明，患有风湿性疾病的肥胖患者在使用抗风湿药治疗期间表现出较低的疾病活动度成活率。在主要的电子数据库（PubMed, Web of Science, Scopus, Embase）中进行了系统的搜索，以确定在肥胖和/或超重的RA或PsA患者以及正常体重的RA或PsA对照受试者中报告MDA达到的研究。结果以比值比（ORs）和相关的95%置信区间（95% ci）表示。我们纳入了17项研究（10项关于RA， 7项关于PsA），共包括6693名患者（1562名患有PsA， 5131名患有RA）。肥胖患者MDA完成率显著低于正常体重组（OR 0.447, 95% CI 0.346 ~ 0.577, p < 0.001, i2 = 62.6%, p < 0.001）。同样，超重患者的MDA实现率明显低于正常体重患者（OR 0.867, 95% CI 0.757-0.994, p = 0.041, i2 = 64%, p = 0.007）。有趣的是，当我们分别分析RA患者和PsA患者的数据时，肥胖对MDA的影响得到了证实。相比之下，当我们评估超重的影响时，我们的结果证实了PsA而不是RA。meta回归分析显示，随访时间、年龄、男性性别和治疗时间是影响肥胖/超重对MDA成就影响的协变量。我们的荟萃分析结果表明，肥胖和超重降低了接受传统或生物疾病缓解抗风湿药物治疗的风湿病患者达到MDA的机会。本文的在线版本（doi:10.1186/s13075-016-1194-8）包含补充材料，可供授权用户使用。
In this study, we evaluated the impact of obesity and/or overweight on the achievement of minimal disease activity (MDA) in patients with psoriatic arthritis (PsA) and patients with rheumatoid arthritis (RA) receiving an anti-rheumatic treatment. Obesity can be considered a low-grade, chronic systemic inflammatory disease and some studies suggested that obese patients with rheumatic diseases exhibit a lower rate of low disease activity achievement during treatment with anti-rheumatic drugs. A systematic search was performed in major electronic databases (PubMed, Web of Science, Scopus, Embase) to identify studies reporting MDA achievement in obese and/or overweight patients with RA or PsA and in normal-weight RA or PsA control subjects. Results were expressed as Odds Ratios (ORs) with pertinent 95% Confidence Intervals (95%CIs). We included 17 studies (10 on RA and 7 on PsA) comprising a total of 6693 patients (1562 with PsA and 5131 with RA) in the analysis. The MDA achievement rate was significantly lower in obese patients than in normal-weight subjects (OR 0.447, 95% CI 0.346–0.577, p < 0.001, I 2 = 62.6%, p < 0.001). Similarly, overweight patients showed a significantly lower prevalence of MDA achievement than normal-weight subjects (OR 0.867, 95% CI 0.757–0.994, p = 0.041, I 2 = 64%, p = 0.007). Interestingly, the effect of obesity on MDA was confirmed when we separately analyzed data on patients with RA and patients with PsA. In contrast, when we evaluated the effect of overweight, our results were confirmed for PsA but not for RA. A meta-regression analysis showed that follow-up duration, age, male sex, and treatment duration are covariates significantly affecting the effect of obesity/overweight on MDA achievement. The results of our meta-analysis suggest that obesity and overweight reduce the chances to achieve MDA in patients with rheumatic diseases receiving treatment with traditional or biologic disease-modifying antirheumatic drugs. The online version of this article (doi:10.1186/s13075-016-1194-8) contains supplementary material, which is available to authorized users.
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