Gamal S M, Alkemary A K, Abdo M A, El Dakrony A H M
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University.
Reumatismo. 2018 Jul 6;70(2):72-77. doi: 10.4081/reumatismo.2018.999.
The aim of the work was to study the relationship between the body mass index (BMI) in longstanding rheumatoid arthritis (RA) and RA disease activity and functional indices. This study included 105 RA patients. For all patients, we recorded the presence of erosions on radiographs, the presence of subcutaneous nodules (SCN), the 28-tender joint count (TJC), 28-swollen joint count (SJC) scores, the visual analogue scale (VAS), physicians' global assessments (PhGA), the erythrocyte sedimentation rate (ESR), and the rheumatoid factor (RF). The disease activity index (DAS28) and BMI were calculated and current treatment was recorded. Patients were divided into two groups: group I: BMI 25. Group I included 32 (30.5%) patients, whereas group II included 73 (69.5%) patients. There were statistically significant differences between the two groups regarding each of the following: SJC (p=0.006), erosions (p=0.006), DAS28 (p=0.016) and PhGA (p=0.007). All were higher in group I (underweight and normal) than in group II (overweight and obese). No statistically significant differences emerged regarding age (p=0.11), smoking (p=0.69), disease duration (p=0.46), TJC (p=0.14), SCN (p=1.00), HAQ (p=0.26), VAS (p=0.16), ESR (p=0.25), RF (p=0.54) and steroid cumulative dose (p=0.08). Low BMI in longstanding RA patients may indicate more active and erosive disease and it may be considered as a poor prognostic factor.
这项工作的目的是研究长期类风湿关节炎（RA）患者的体重指数（BMI）与RA疾病活动度和功能指标之间的关系。本研究纳入了105例RA患者。对于所有患者，我们记录了X线片上侵蚀的存在情况、皮下结节（SCN）的存在情况、28个压痛关节计数（TJC）、28个肿胀关节计数（SJC）评分、视觉模拟量表（VAS）、医生整体评估（PhGA）、红细胞沉降率（ESR）和类风湿因子（RF）。计算疾病活动指数（DAS28）和BMI，并记录当前治疗情况。患者分为两组：第一组：BMI＜25。第一组包括32例（30.5%）患者，而第二组包括73例（69.5%）患者。两组在以下各项方面存在统计学显著差异：SJC（p = 0.006）、侵蚀（p = 0.006）、DAS28（p = 0.016）和PhGA（p = 0.007）。所有这些指标在第一组（体重过轻和正常体重）中均高于第二组（超重和肥胖）。在年龄（p = 0.11）、吸烟（p = 0.69）、病程（p = 0.46）、TJC（p = 0.14）、SCN（p = 1.00）、HAQ（p = 0.26）、VAS（p = 0.16）、ESR（p = 0.25）、RF（p = 0.54）和类固醇累积剂量（p = 0.08）方面未出现统计学显著差异。长期RA患者的低BMI可能表明疾病更活跃且有侵蚀性，可被视为不良预后因素。
