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肥胖和超重对类风湿关节炎患者 C 反应蛋白浓度和疾病活动度的影响:系统评价和荟萃分析。

Impact of obesity and overweight on C-reactive protein concentrations and disease activity in rheumatoid arthritis: A systematic review and meta-analysis.

机构信息

Rheumatology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.

Plataforma INVEST UANL-KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico.

出版信息

Int J Rheum Dis. 2023 Dec;26(12):2498-2508. doi: 10.1111/1756-185X.14948. Epub 2023 Oct 27.

Abstract

AIM

This study aims to assess the association of obesity and CRP concentrations in adult patients with rheumatoid arthritis (RA), and its influence on measures of disease activity.

METHODS

A comprehensive search was performed using Scopus, Web of Science, MEDLINE, and EMBASE, from the time of their inception to November 2021. Observational studies that evaluated the association between CRP concentrations and obesity or overweight in patients with RA were considered eligible. Correlation coefficients were pooled using the inverse variance method, while effect sizes were pre-calculated for adjusted standardized regression coefficients (β).

RESULTS

A total of 10 studies, which comprised 4024 patients, were included in this systematic review. Individually, most studies report a significant association between CRP concentrations and a higher body mass index or other adiposity measures, but the statistical significance was not sustained when pooling their data together. Through the estimates provided in the present review, it is noted that CRP tends to be more elevated in female patients with RA that have a higher BMI. However, this association is not present in men.

CONCLUSION

CRP tends to be elevated in female patients with RA that have a higher BMI. Further research is required to assess this possible sex-related difference and to aid shared decision-making in order to avoid over-treatment and increased burden in patients with obesity and RA. PROSPERO registration number: CRD42022314580.

摘要

目的

本研究旨在评估肥胖症与类风湿关节炎(RA)成年患者 C 反应蛋白(CRP)浓度之间的相关性,以及其对疾病活动度指标的影响。

方法

通过 Scopus、Web of Science、MEDLINE 和 EMBASE 数据库,从建库开始到 2021 年 11 月进行全面检索,评估 CRP 浓度与 RA 患者肥胖或超重之间相关性的观察性研究纳入本系统评价。采用Inverse variance 法对相关系数进行合并,采用预先计算的调整标准化回归系数(β)进行效应量合并。

结果

本系统评价共纳入 10 项研究,共计 4024 例患者。单独来看,大多数研究报告 CRP 浓度与较高的体重指数或其他肥胖指标之间存在显著相关性,但综合分析这些数据时,这种统计学关联并不成立。根据本综述提供的估计值,RA 女性患者的 CRP 水平往往随着 BMI 的升高而升高。然而,这种关联在男性患者中并不存在。

结论

RA 女性患者的 CRP 水平往往随着 BMI 的升高而升高。需要进一步研究以评估这种可能存在的性别差异,并为肥胖和 RA 患者的共同决策提供帮助,以避免过度治疗和增加患者负担。PROSPERO 注册号:CRD42022314580。

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