Stavropoulos-Kalinoglou Antonios, Metsios Giorgos S, Panoulas Vasileios F, Nevill Alan M, Jamurtas Athanasios Z, Koutedakis Yiannis, Kitas George D
School of Sport, Performing Arts and Leisure, Wolverhampton University, Gorway Road, Walsall WS1 3BD, West Midlands, UK.
Clin Rheumatol. 2009 Apr;28(4):439-44. doi: 10.1007/s10067-008-1073-z. Epub 2008 Dec 19.
Obesity is characterised by low-grade inflammation and could potentially affect disease activity and severity in patients with rheumatoid arthritis (RA). Body mass index (BMI), body fat (BF), erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, physical function (health assessment questionnaire) and presence of erosions and joint surgery were assessed in 294 (female=219) volunteers with established RA [age 63.3 (56.2-69.6); disease duration 13 (7-20) years]. Smoking status, rheumatoid factor and anti-cyclic citrullinated peptide positivity were also assessed. BMI and BF independently associated with disease characteristics. Compared to normal-weight patients, underweight and obese had higher C-reactive protein (p=0.046) and physical dysfunction (p=0.034). BMI or BF did not associate with presence of erosions or joint surgery. In patients with established RA, both very low and very high BMI and BF associate independently with increased disease activity and physical dysfunction; however, this does not seem to associate with presence of erosions or joint surgery. Further longitudinal studies are required to address this apparent dissociation.
肥胖的特征是低度炎症，可能会影响类风湿关节炎（RA）患者的疾病活动度和严重程度。对294名（女性219名）确诊为RA的志愿者[年龄63.3（56.2 - 69.6）岁；病程13（7 - 20）年]进行了体重指数（BMI）、体脂（BF）、红细胞沉降率、C反应蛋白、疾病活动评分28、身体功能（健康评估问卷）以及是否存在侵蚀和关节手术情况的评估。还评估了吸烟状况、类风湿因子和抗环瓜氨酸肽阳性情况。BMI和BF分别与疾病特征相关。与体重正常的患者相比，体重过轻和肥胖患者的C反应蛋白水平更高（p = 0.046），身体功能障碍更严重（p = 0.034）。BMI或BF与侵蚀或关节手术的存在无关。在确诊为RA的患者中，极低和极高的BMI及BF均分别与疾病活动度增加和身体功能障碍相关；然而，这似乎与侵蚀或关节手术的存在无关。需要进一步的纵向研究来解决这种明显的脱节现象。
