Department of Epidemiology and Health Statistics, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, China.
Department of Rheumatology, Liaocheng People's Hospital, Liaocheng, China.
Biomed Res Int. 2019 Jul 2;2019:3579081. doi: 10.1155/2019/3579081. eCollection 2019.
Extensive studies have been carried out to investigate the association between obesity and the risk of rheumatoid arthritis (RA); however, the results of the current reported original studies remain inconsistent. This study aimed to clarify the relationship between body mass index and rheumatoid arthritis by conducting an updated overall and dose-response meta-analysis.
The relevant literature was searched using the PubMed and Embase databases (through 20 September 2018) to identify all eligible published studies. Random-effect models and dose-response meta-analyses were used to estimate the pooled risk ratio (RR) with a 95% confidence interval (CI). Subgroup analyses were also conducted based on the characteristics of the participants. Sensitivity analyses and publication bias tests were also performed to explore potential heterogeneity and bias in the meta-analysis.
Sixteen studies that included a total of 406,584 participants were included in the meta-analysis. Compared to participants with normal weight, the pooled RRs of rheumatoid arthritis were 1.12 (95% CI, 1.04-1.20) in overweight and 1.23 (95% CI, 1.09-1.39) in obese participants. There was evidence of a nonlinear relationship between body mass index (BMI) and RA (for nonlinearity less than 0.001 in the overall meta-analysis, for nonlinearity=0.025 in the case-control studies, for nonlinearity=0.0029 in the cohort studies). No significant heterogeneity was found among studies ( =10.9% for overweight and =45.5% for obesity).
The overall and dose-response meta-analysis showed that increased BMI was associated with an increased risk for rheumatoid arthritis, which might present a prevention strategy for the prevention or control of rheumatoid arthritis. The nonlinear relationship between BMI and RA might present a personal prevention strategy for RA.
大量研究已经探讨了肥胖与类风湿关节炎（RA）风险之间的关联；然而，目前报道的原始研究结果仍然不一致。本研究旨在通过进行更新的综合和剂量反应荟萃分析来阐明体重指数与类风湿关节炎之间的关系。
使用 PubMed 和 Embase 数据库（截至 2018 年 9 月 20 日）搜索相关文献，以确定所有合格的已发表研究。使用随机效应模型和剂量反应荟萃分析来估计合并风险比（RR）及其 95%置信区间（CI）。还根据参与者的特征进行了亚组分析。进行敏感性分析和发表偏倚检验，以探索荟萃分析中的潜在异质性和偏倚。
纳入了荟萃分析的 16 项研究共纳入了 406584 名参与者。与体重正常的参与者相比，超重者患 RA 的合并 RR 为 1.12（95%CI，1.04-1.20），肥胖者为 1.23（95%CI，1.09-1.39）。体重指数（BMI）与 RA 之间存在非线性关系（总体荟萃分析中非线性程度小于 0.001，病例对照研究中非线性程度=0.025，队列研究中非线性程度=0.0029）。研究之间没有发现显著的异质性（超重研究的=10.9%，肥胖研究的=45.5%）。
综合和剂量反应荟萃分析表明，BMI 增加与类风湿关节炎风险增加相关，这可能为类风湿关节炎的预防或控制提供一种预防策略。BMI 与 RA 之间的非线性关系可能为 RA 的个体化预防策略提供依据。
