Is the relationship between deprivation and outcomes in rheumatoid arthritis mediated by body mass index? A longitudinal cohort study
Authors' conclusion
People with RA living in deprived areas have a higher burden of disease, which is partly mediated through obesity.
Study context
- Population
- People with RA commencing MTX for the first time, rheumatology centres across England (Rheumatoid Arthritis Medication Study (RAMS))1,529 (HAQ-Disability Index (HAQ-DI)) and 1626 (DAS28) included
- Exposure
- Highest vs lowest deprivation fifths; obesity vs no obesity
- Outcome
- Repeated measures HAQ-DI and DAS28; mediating effect of BMI on deprivation–outcome relationship
- Follow-up
- 6 or 12 months
Methodological detailsmulticentre, observational, longitudinal, linear mixed models, causal mediation analysis
- Multicentre
- Observational
- Longitudinal
- Linear mixed models
- Causal mediation analysis
Main finding
As reported in the abstract
- Highest deprivation fifth vs Lowest deprivation fifth
- adjusted regression coefficient (HAQ-DI) 0.32 (95% CI 0.19–0.45)
- Obesity vs No obesity
- adjusted regression coefficient (HAQ-DI) 0.13 (95% CI 0.06–0.20)
- Highest deprivation fifth vs Lowest deprivation fifth
- adjusted regression coefficient (DAS28) 0.34 (95% CI 0.11–0.58)
- Obesity vs No obesity
- adjusted regression coefficient (DAS28) 0.17 (95% CI 0.04–0.31)
- Proportion of deprivation–disability association mediated by BMI
- 14.24%
- Proportion of deprivation–DAS association mediated by BMI
- 17.26%
Observational data: associations, not effects.
Original publication
Is the relationship between deprivation and outcomes in rheumatoid arthritis mediated by body mass index? A longitudinal cohort study. Rheumatology (Oxford). Published 28 November 2022. doi:10.
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