Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Joint Bone Spine. 2023 Sep;90(5):105576. doi: 10.1016/j.jbspin.2023.105576. Epub 2023 Apr 18.
To evaluate the impact of obesity in patients with adult-onset Still's disease (AOSD) and to assess their clinical characteristics and disease outcomes.
The clinical features of AOSD patients with a body mass index (BMI)≥30 were assessed among those included in the multicentre Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale (GIRRCS) cohort.
Out of 139 AOSD patients, who had BMI registered in our database, 26 (18.7%) had a BMI≥30. A lower rate of sore throat (P<0.05), pericarditis (P<0.05), and pleuritis (P<0.05) was shown in obese patients. Additionally, obese patients showed higher values of C-reactive protein (CRP) (P<0.05) and ferritin (P<0.05) than others. Furthermore, obese patients were characterised by biologic disease-modifying antirheumatic drug (bDMARD) failure in subsequent follow-up (P<0.05). They also presented higher rate of comorbidity than non-obese patients (P<0.05). Finally, obesity predicted the presence of a chronic disease course in both univariate (HR: 1.72, 95%CI: 1.03-2.51, P<0.05) and multivariate analyses (HR: 1.85, 95%CI: 1.45-2.89, P<0.05). Obesity was also a significant predictor of bDMARD failure in AOSD patients in both univariate (HR: 3.03, 95%CI: 1.42-6.45, P<0.01) and multivariate analyses (HR: 3.59, 95%CI: 1.55-8.27, P<0.01).
Obese patients at the time of diagnosis of the disease were characterised by a lower prevalence of sore throat, serositis, as well as by higher values of CRP and ferritin. Obesity was also a predictive factor for a chronic disease course and bDMARD failure, thus highlighting a subset of patients with AOSD to be carefully managed.
评估肥胖对成年Still 病（AOSD）患者的影响，并评估其临床特征和疾病结局。
评估了多中心意大利临床和实验风湿病研究组（GIRRCS）队列中纳入的 AOSD 患者中 BMI≥30 的患者的临床特征。
在我们数据库中登记 BMI 的 139 例 AOSD 患者中，有 26 例（18.7%）的 BMI≥30。肥胖患者的咽痛（P<0.05）、心包炎（P<0.05）和胸膜炎（P<0.05）发生率较低。此外，肥胖患者的 C 反应蛋白（CRP）（P<0.05）和铁蛋白（P<0.05）值较高。此外，肥胖患者在随后的随访中存在生物改善病情抗风湿药物（bDMARD）失败（P<0.05）。与非肥胖患者相比，肥胖患者的合并症发生率也较高（P<0.05）。最后，肥胖在单因素（HR：1.72，95%CI：1.03-2.51，P<0.05）和多因素分析（HR：1.85，95%CI：1.45-2.89，P<0.05）中均预测 AOSD 患者存在慢性病程。肥胖也是 AOSD 患者 bDMARD 失败的一个重要预测因素，在单因素（HR：3.03，95%CI：1.42-6.45，P<0.01）和多因素分析（HR：3.59，95%CI：1.55-8.27，P<0.01）中也是如此。
疾病诊断时肥胖患者的咽痛、浆膜炎发生率较低，CRP 和铁蛋白值较高。肥胖也是慢性病程和 bDMARD 失败的预测因素，这突出了 AOSD 患者中需要谨慎管理的亚组。
