University of California, San Francisco.
University of California, San Francisco, and San Francisco VA Hospital, San Francisco, California.
Arthritis Care Res (Hoboken). 2019 Jan;71(1):126-133. doi: 10.1002/acr.23576.
To determine whether obesity in women with systemic lupus erythematosus (SLE) is independently associated with worse patient-reported outcomes (PROs).
Data were derived from a prospective study of adult women with a diagnosis of SLE that was verified by medical record review. Two established definitions for obesity were used: fat mass index (FMI) ≥13 kg/m and body mass index (BMI) ≥30 kg/m . Dependent variables included 4 validated PROs: disease activity as assessed by the Systemic Lupus Activity Questionnaire (SLAQ), depressive symptoms as assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), pain as assessed by the Short Form 36 (SF-36) pain subscale, and fatigue as assessed by the SF-36 vitality subscale. We used multivariable linear regression to evaluate the associations of obesity with PROs, while controlling for potential confounders (age, race, education, income, smoking, disease duration, disease damage, and prednisone use).
The analysis included 148 participants, 32% of whom were obese. In the multivariate regression model, obesity was associated with worse scores for each PRO. Mean adjusted scores for the SLAQ and CES-D comparing obese versus non-obese participants were 14.8 versus 11.5 (P = 0.01) and 19.8 versus 13.1 (P < 0.01), respectively. The obese group also reported worse mean adjusted scores for pain (38.7 versus 44.2; P < 0.01) and fatigue (39.6 versus 45.2; P = 0.01).
In a representative sample of women with SLE, obesity (as defined by both FMI and BMI) was independently associated with worse PROs, including disease activity, depressive symptoms, and symptoms of pain and fatigue. Obesity may represent a modifiable target for improving outcomes among obese women with SLE.
确定红斑狼疮（SLE）女性肥胖是否与较差的患者报告结局（PROs）独立相关。
数据来自一项经病历审查确诊为成人女性 SLE 的前瞻性研究。使用两种既定的肥胖定义：脂肪质量指数（FMI）≥13 kg/m2和体重指数（BMI）≥30 kg/m2。依赖变量包括 4 种经过验证的 PROs：通过系统性红斑狼疮活动问卷（SLAQ）评估的疾病活动度、通过中心流行病学研究抑郁量表（CES-D）评估的抑郁症状、通过简短形式 36 项健康调查量表（SF-36）疼痛子量表评估的疼痛以及通过 SF-36 活力子量表评估的疲劳。我们使用多变量线性回归来评估肥胖与 PROs 的关联，同时控制潜在的混杂因素（年龄、种族、教育、收入、吸烟、疾病持续时间、疾病损害和泼尼松使用）。
分析包括 148 名参与者，其中 32%为肥胖者。在多元回归模型中，肥胖与每种 PRO 的评分较差相关。肥胖组与非肥胖组相比，SLAQ 和 CES-D 的平均调整后评分分别为 14.8 与 11.5（P = 0.01）和 19.8 与 13.1（P < 0.01）。肥胖组的疼痛（38.7 与 44.2；P < 0.01）和疲劳（39.6 与 45.2；P = 0.01）的平均调整后评分也较差。
在具有代表性的 SLE 女性样本中，肥胖（根据 FMI 和 BMI 定义）与较差的 PROs 独立相关，包括疾病活动度、抑郁症状以及疼痛和疲劳症状。肥胖可能是改善肥胖 SLE 女性结局的可修正目标。
