Department of Pharmacy, National University of Singapore, Singapore, Singapore.
Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Clin Rheumatol. 2017 Oct;36(10):2365-2370. doi: 10.1007/s10067-017-3585-x. Epub 2017 Apr 4.
To determine if obesity is associated with poorer patient-reported outcomes (PROs) in patients with axial spondyloarthritis (axSpA), we conducted a cross-sectional study using data of the PRESPOND registry from a tertiary referral center in Singapore between 2011 and 2015. Demographics, clinical, and PRO variables were collected. Patients were divided into three categories: normal (BMI < 23 kg/m), overweight (23 kg/m ≤ BMI < 27.5 kg/m) and obese (BMI ≥ 27.5 kg/m), using Asian BMI classification. The dependent variables are Pain score, Bath Ankylosing Spondylitis Patient Global Score (BAS-G), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Health Assessment Questionnaire (HAQ), and Medical Outcomes Study Short Form 36 version 2 (SF-36). Multivariate regression analyses were performed with these dependent variables and obesity categories, adjusting for confounders. Among 194 patients with axSpA, 32% are overweight while 22% are obese. We found that obese patients had significant poorer pain (β: 11.87, 95%CI 2.13, 21.60) and BAS-G scores (β: 10.18, 95%CI 1.59, 18.76) when compared to normal BMI patients. However, obesity was not associated with BASDAI (β 0.50, 95%CI -0.22, 1.22), BASFI (β 0.08, 95%CI -0.66, 0.81), HAQ (β -0.07, 95%CI -0.21, 0.06), physical component summary (β -0.02, 95%CI -4.47, 4.44), and mental component summary (β -2.85, 95%CI -7.57, 1.88) of SF-36. Obesity was associated with pain score and BAS-G but not with BASDAI, BASFI, HAQ, and SF-36. Further study is needed to examine the causal relationship between obesity and poorer PROs.
为了确定肥胖是否与患有中轴型脊柱关节炎（axSpA）患者的较差患者报告结局（PRO）相关，我们在新加坡的一家三级转诊中心进行了一项横断面研究，使用了 PRESPOND 登记处的数据，研究时间为 2011 年至 2015 年。收集了人口统计学、临床和 PRO 变量。使用亚洲 BMI 分类，将患者分为三类：正常（BMI<23kg/m）、超重（23kg/m≤BMI<27.5kg/m）和肥胖（BMI≥27.5kg/m）。因变量是疼痛评分、 Bath 强直性脊柱炎患者总体评分（BAS-G）、 Bath 强直性脊柱炎疾病活动指数（BASDAI）、 Bath 强直性脊柱炎功能指数（BASFI）、健康评估问卷（HAQ）和医疗结局研究简表 36 版（SF-36）。对这些因变量和肥胖类别进行了多元回归分析，同时调整了混杂因素。在 194 名 axSpA 患者中，32%为超重，22%为肥胖。我们发现与正常 BMI 患者相比，肥胖患者的疼痛（β：11.87，95%CI 2.13，21.60）和 BAS-G 评分（β：10.18，95%CI 1.59，18.76）明显较差。然而，肥胖与 BASDAI（β 0.50，95%CI -0.22，1.22）、BASFI（β 0.08，95%CI -0.66，0.81）、HAQ（β -0.07，95%CI -0.21，0.06）、物理成分综合评分（β -0.02，95%CI -4.47，4.44）和精神成分综合评分（β -2.85，95%CI -7.57，1.88）无显著相关性。肥胖与疼痛评分和 BAS-G 相关，但与 BASDAI、BASFI、HAQ 和 SF-36 无关。需要进一步的研究来检验肥胖与较差 PRO 之间的因果关系。
