Central Obesity in Axial Spondyloarthritis: The Missing Link to Understanding Worse Outcomes in Women?

Q2 Medicine

The Journal of rheumatology. Supplement Pub Date : 2022-03-01 DOI:10.3899/jrheum.211062

S. Maguire, F. Wilson, P. Gallagher, F. O’Shea

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引用次数: 4

Abstract

Objective. To determine (1) the prevalence of central obesity in axial spondyloarthritis (axSpA) and its effect on disease-related outcomes and (2) how this differs between sexes. Methods. Data were extracted from the Ankylosing Spondylitis Registry of Ireland. Patients with physical measurements for the calculation of anthropometric measures were included. BMI and waist-to-hip ratio (WHR) were used to compare classifications of obesity. Comparison analyses based on sex and central obesity were carried out. Multivariate analysis examined the effects of these factors on the following patient-reported outcomes: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, and the Health Assessment Questionnaire (HAQ). Results. In total, 753 patients were included in the analysis. Of these patients, 29.6% (n = 223) were classified as obese based on their BMI, and 41.3% (n = 311) were classified as centrally obese according to the WHR. The prevalence of central obesity was significantly higher among women with axSpA compared to men (71.6% vs 29.9%, P < 0.01). Central obesity had a clear effect on patient outcomes, regardless of sex. Presence of central obesity was associated with significantly worse BASFI scores (P < 0.01), HAQ scores (P < 0.01), and ASQoL questionnaire scores (P = 0.01), with a nonsignificant trend toward worse BASDAI scores (P = 0.07). Conclusion. There was a high prevalence of central obesity as assessed by the WHR in axSpA, most notably among women with axSpA. This modifiable comorbidity was significantly associated with worse quality of life, greater impairment of functional ability, and a trend toward worse disease activity. Regular use of the WHR to screen for central obesity as part of an axSpA assessment would provide an opportunity for prompt identification and intervention for at-risk patients.

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中枢性肥胖与中枢性脊柱性关节炎:了解女性不良预后的缺失环节?

目标。确定(1)中枢性肥胖在中枢性脊柱炎(axSpA)中的患病率及其对疾病相关结局的影响，以及(2)这在性别之间的差异。方法。数据来自爱尔兰强直性脊柱炎登记处。计算人体测量值的体格测量患者也包括在内。BMI和腰臀比(WHR)被用来比较肥胖的分类。进行了基于性别和中心性肥胖的比较分析。多变量分析检查了这些因素对以下患者报告结果的影响:强直性脊柱炎疾病活动指数(BASDAI)、强直性脊柱炎功能指数(BASFI)、强直性脊柱炎生活质量(ASQoL)问卷和健康评估问卷(HAQ)。结果。共有753例患者被纳入分析。其中，29.6% (n = 223)的患者根据BMI被归类为肥胖，41.3% (n = 311)的患者根据WHR被归类为中心肥胖。患有axSpA的女性中心性肥胖的患病率明显高于男性(71.6% vs 29.9%， P < 0.01)。中心性肥胖对患者的预后有明显的影响，与性别无关。中心性肥胖与较差的BASFI评分(P < 0.01)、HAQ评分(P < 0.01)和ASQoL问卷评分(P = 0.01)显著相关，但与较差的BASDAI评分无显著相关性(P = 0.07)。结论。经腰宽比评估，axSpA患者中枢性肥胖的患病率很高，尤其是在患有axSpA的女性中。这种可改变的共病与更差的生活质量、更大的功能损害以及更严重的疾病活动性趋势显著相关。作为axSpA评估的一部分，定期使用腰宽比来筛查中心性肥胖，将为高危患者提供及时识别和干预的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Journal of rheumatology. Supplement Medicine-Medicine (all)

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期刊介绍： The Journal of Rheumatology is a monthly international serial edited by Duncan A. Gordon, The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 36 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.