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加拿大类风湿性关节炎患者中肥胖率较高且相关残疾情况更为严重。

High rates of obesity and greater associated disability among people with rheumatoid arthritis in Canada.

作者信息

Colmegna Inés, Hitchon Carol A, Bardales María Celia Bazán, Puri Lekha, Bartlett Susan J

机构信息

Division of Rheumatology, Department of Medicine, McGill University, 687 Pine Avenue, room E287, Montreal, QC, H3A 1A1, Canada.

Royal Victoria Hospital, Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Bloc E, M2-3238, Montréal, QC, H4A 3J1, Canada.

出版信息

Clin Rheumatol. 2016 Feb;35(2):457-60. doi: 10.1007/s10067-015-3154-0. Epub 2015 Dec 28.

Abstract

Obesity in rheumatoid arthritis has been associated with increased risk of comorbidities, larger medical costs, decreased quality of life, higher disease activity, and reduced therapeutic responses. We assessed the burden of obesity among rheumatoid arthritis patients and its impact on patient-reported outcomes. Patients receiving care at two Canadian University Centers were included. Height and weight were measured and selected sociodemographic and rheumatoid arthritis (RA) characteristics as well as patient-reported outcomes were obtained. Patients were classified according to WHO criteria and proposed RA cut points, and results were compared with national data. Using WHO criteria, 68 (34 %) RA patients were classified as obese (vs. ~25 % of Canadians). Using RA cut points, 112 (55 %) RA patients were classified as obese. With both classification methods, obese individuals had significantly higher mean HAQ scores and a higher odds of significant disability (HAQ ≥ 1: WHO OR 2.3; 95 % CI 1.2, 4.2 and RA-specific OR 1.8; 95 % CI 1.0, 3.2). Independent of the classification method use, RA patients have significantly higher rates of obesity than national prevalence estimates. Obese RA patients had about twice the odds of reporting moderate to severe disability.

摘要

类风湿关节炎患者肥胖与共病风险增加、医疗费用增加、生活质量下降、疾病活动度升高以及治疗反应降低有关。我们评估了类风湿关节炎患者的肥胖负担及其对患者报告结局的影响。纳入了在两个加拿大大学中心接受治疗的患者。测量了身高和体重,并获取了选定的社会人口统计学和类风湿关节炎(RA)特征以及患者报告结局。根据世界卫生组织(WHO)标准和提议的RA切点对患者进行分类,并将结果与国家数据进行比较。使用WHO标准,68名(34%)RA患者被分类为肥胖(相比之下,加拿大人中约为25%)。使用RA切点,112名(55%)RA患者被分类为肥胖。采用这两种分类方法时,肥胖个体的平均健康评估问卷(HAQ)得分显著更高,且出现严重残疾的几率更高(HAQ≥1:WHO比值比2.3;95%置信区间1.2,4.2;以及RA特异性比值比1.8;95%置信区间1.0,3.2)。无论使用何种分类方法,RA患者的肥胖率均显著高于国家患病率估计值。肥胖的RA患者报告中度至重度残疾的几率约为两倍。

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