Thrum S
Klinik für Gastroenterologie und Rheumatologie, Sektion Rheumatologie/Gerontologie, Universitätsklinikum Leipzig AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
Z Rheumatol. 2017 May;76(4):348-350. doi: 10.1007/s00393-017-0298-0.
Adipose tissue possesses crucial immunological features in the development of comorbidities of obesity. Complex interactions between the metabolic system and cells of the immune system are the cause but are not fully understood. Autoimmune diseases might therefore be influenced by obesity. Epidemiological studies provide evidence of only a modest association between obesity and the development of rheumatoid arthritis and psoriatic arthritis. In obesity the course of inflammatory rheumatic diseases is aggravated, as subjectively measured by activity parameters; however, laboratory parameters show no differences and radiographic examinations reveal less bone destruction in obesity. Furthermore, there are indications for a poorer response to treatment especially with infliximab in patients with an increased body mass index (BMI). Weight loss has a positive effect on the course of joint diseases. Due to deficits in the currently available studies there is insufficient evidence to recommend individualization of treatment decisions based on the BMI.
脂肪组织在肥胖症合并症的发展过程中具有关键的免疫学特征。代谢系统与免疫系统细胞之间的复杂相互作用是其原因，但尚未完全了解。因此，自身免疫性疾病可能会受到肥胖的影响。流行病学研究仅提供了肥胖与类风湿性关节炎和银屑病关节炎发展之间适度关联的证据。在肥胖症中，炎症性风湿性疾病的病程会加重，这是通过活动参数主观测量得出的；然而，实验室参数并无差异，且影像学检查显示肥胖症患者的骨质破坏较少。此外，有迹象表明，体重指数（BMI）升高的患者对治疗的反应较差，尤其是对英夫利昔单抗的反应。体重减轻对关节疾病的病程有积极影响。由于现有研究存在缺陷，没有足够的证据推荐根据BMI对治疗决策进行个体化。
