Popescu C, Bojincă Violeta, Opriş Daniela, Ionescui Ruxandra
Rom J Intern Med. 2015 Jul-Sep;53(3):237-47. doi: 10.1515/rjim-2015-0031.
Rheumatoid arthritis (RA) may influence not only abdominal fat, but also whole body adiposity, since it is associated with chronic inflammation and disability. The study aims to evaluate the whole body adiposity of RA patients and to assess potential influences of disease specific measures.
The study was designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. Each subject underwent on the same day clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire.
A total of 107 RA women and 104 matched controls were included. Compared to controls, the RA group had less physical activity and a higher prevalence of normal weight obesity. Overfat RA women had a significantly higher toll of inflammation, disease activity, glucocorticoid treatment and sedentary behavior. RA women with inflammation, glucocorticoid treatment and higher disease activity class had higher whole body and trunk adipose tissue indices and higher prevalence of overfat status. Glucocorticoid treatment, inflammation, disease duration and severity correlated with whole body adipose tissue and significantly predicted high adiposity content and overfat phenotypes.
RA disease duration and severity are associated with higher whole body and regional adiposity. Low-dose glucocorticoid treatment seems to contribute to adiposity gain and redistribution. Clinicians may need to assess body composition and physical activity in RA patients in order to fully manage cardiovascular outcomes and quality of life.
类风湿关节炎(RA)可能不仅影响腹部脂肪,还会影响全身肥胖情况,因为它与慢性炎症和残疾相关。本研究旨在评估RA患者的全身肥胖情况,并评估疾病特异性指标的潜在影响。
本研究纳入了白种人绝经后女性RA患者和年龄匹配的绝经后女性对照。每位受试者在同一天接受临床检查、实验室检测、全身双能X线吸收法(DXA)成分分析以及使用自填问卷进行的身体活动评估。
共纳入107名RA女性和104名匹配的对照。与对照组相比,RA组的身体活动较少,正常体重肥胖的患病率较高。超重的RA女性炎症、疾病活动度、糖皮质激素治疗和久坐行为的负担明显更高。患有炎症、接受糖皮质激素治疗且疾病活动度较高的RA女性全身和躯干脂肪组织指数更高,超重状态的患病率也更高。糖皮质激素治疗、炎症、疾病持续时间和严重程度与全身脂肪组织相关,并显著预测高肥胖含量和超重表型。
RA的疾病持续时间和严重程度与更高的全身和局部肥胖相关。低剂量糖皮质激素治疗似乎会导致肥胖增加和重新分布。临床医生可能需要评估RA患者的身体成分和身体活动,以便全面管理心血管结局和生活质量。