Patients with obesity have more inflamed joints and higher CRP levels during the disease course in ACPA-positive RA but not in ACPA-negative RA
Authors' conclusion
The association of obesity with a worse DAS course is mainly present in ACPA-positive RA; especially SJC and CRP levels remain higher in ACPA-positive RA patients with obesity but not ACPA-negative RA patients.
Study context
- Population
- RA patients included in the Leiden Early Arthritis Clinic291 ACPA-positive
- Participants
- 649 patients
- Exposure
- Obesity and overweight vs normal weight, stratified for ACPA
- Outcome
- Course of DAS44 and DAS44 components (SJC-44, TJC-53, CRP, VAS 0-100)
- Follow-up
- 5 years
Methodological detailsstratified for ACPA, linear/Poisson mixed models with a knot at 4 months
- Stratified for ACPA
- linear/Poisson mixed models with a knot at 4 months
Main finding
As reported in the abstract
Difference
+ 0.32
total RA
Difference
+ 0.43
95% CI 0.22–0.64
ACPA-positive RA
Difference
+ 0.19
95% CI - 0.01, 0.38
ACPA-negative RA; not statistically significant
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| DAS components (SJC-44, CRP, TJC-53, VAS) in ACPA-positive RA, obese vs normal weight · 5-year follow-upObesityvs Normal weightSJC + 60% | IRR (SJC) 1.60 (95% CI 1.18–2.16) | |
| DAS components (SJC-44, CRP, TJC-53, VAS) in ACPA-positive RA, obese vs normal weight · 5-year follow-upObesityvs Normal weightTJC + 55% | IRR (TJC) 1.55 (95% CI 1.15–2.10) | |
| 0.512Ratio (log scale) |
| Outcome | Estimate |
|---|---|
| DAS components (SJC-44, CRP, TJC-53, VAS) in ACPA-positive RA, obese vs normal weight · 5-year follow-upObesity vs Normal weight | difference (CRP) + 3.7 mg/L (95% CI 0.95–6.53) |
| DAS components (SJC-44, CRP, TJC-53, VAS) in ACPA-positive RA, obese vs normal weight · 5-year follow-upObesity vs Normal weight | difference (VAS) + 9 (95% CI 4.0–14.2) |
Disease activity scores (DAS) components (SJC-44, CRP, TJC-53, VAS) in ACPA-positive RA, obese vs normal weight · 5-year follow-up
- All DAS components significantly higher in obese patients compared to normal weight
DAS components (tender joint count (TJC), VAS, swollen joint count (SJC), CRP) in ACPA-negative RA, obese RA patients · 5-year follow-up
- TJC (tended to be higher), IRR
- 1.22 (95% CI: 0.96, 1.55)
- VAS (tended to be higher), β
- 4.3 (95% CI: - 0.4, 9.0)
- SJC (unaffected), IRR
- 1.07 (95% CI:0.85, 1.33)
- CRP (unaffected), β
- 0.24 (95% CI: - 1.29, 3.32)
Original publication
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