Relation between body mass index and radiological progression in patients with rheumatoid arthritis
Kaufmann, Jörg.; Kielstein, V.; Kilian, S.; Stein, Günter.; Hein, G.
Journal of Rheumatology 30(11): 2350-2355
2003
ISSN/ISBN: 0315-162X PMID: 14677176 Document Number: 552862
Objective: To determine if there is an influence of body mass index (BMI) on the radiological progression in early and longer duration rheumatoid arthritis (RA). Methods: Fifty-four patients with RA were observed in a progressive 2 year follow up for radiological progression of joint damage [Germany]. At the beginning of study, 27 (50%) patients had a duration of complaints less than 6 months, grouped as early RA. BMI at the beginning and end of the study were monitored, together with HLA-DRB1 alleles, initial joint erosions, duration of disease, age, sex, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Outcome was defined as radiographic damage according to yearly increase of Larsen score. Results: Increased radiographic joint damage of patients was significantly correlated with lower BMI at the beginning of the study (r=0.363, p<0.05), the presence of initial joint erosions (r=0.341, p<0.01), ESR (r=0.315, p<0.05), and CRP at study entry (r=0.427, p<0.01). Patients with an increase of Larsen score >=5.8/year were found to have a lower weight at the beginning of their complaints (BMI 24.8+or-4.7 vs 27.8+or-3.8; p<0.05) as well as after the time of observation (BMI 24.6+or-3.7 vs 27.6+or-4.9; p<0.05). Stepwise logistic regression analysis revealed a BMI<27 at the beginning of disease ( beta =2.04, p=0.003, odds ratio=7.69), the presence of HLA-DR4 shared epitope ( beta =1.76, p=0.015, OR 5.82), and joint erosions at study entry ( beta =1.56, p=0.044, OR 4.78) as significant predictors for rapid joint damage. Conclusion: Together with the presence of HLA-DR4 shared epitope and erosive disease at study entry, a low BMI at the beginning of RA was found in association with higher radiographic progression in RA. Accordingly, BMI could be of interest as a sensitive and inflammation-independent predictor for radiological outcome of RA.