Pan Jie, Wu Tao, Zou Yao-Wei, Li Qi-Hua, Ouyang Zhi-Ming, Ma Jian-Da, Jia Pei-Wen, Zheng Hu-Wei, Lin Jian-Zi, Lu Ye, Yang Ying, Chen Le-Feng, Yang Kui-Min, Dai Jun, Dai Lie
Department of Rheumatology and Immunology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P.R. China.
Department of Rheumatology and Immunology, Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, P.R. China.
Rheumatol Adv Pract. 2024 Jul 5;8(3):rkae080. doi: 10.1093/rap/rkae080. eCollection 2024.
To characterize BMI in Chinese patients with RA US patients and examine its association with joint damage in Chinese patients.
Each of the 1318 patients from a real-world Chinese RA population was first stratified by gender and then individually age-matched with one American RA patient from the US National Health and Nutritional Examination Survey 1999-2018. Data on BMI, bilateral hand radiographs and risk factors at enrolment were collected but radiographs were unavailable for the American patients. Logistic regression was used to evaluate the association of BMI with radiographic joint damage (RJD) in Chinese patients.
Chinese patients had a significantly lower BMI [(weighted) median 21.8 29.8 kg/m; < 0.001] and a higher prevalence of being underweight (15.2% 1.1%; < 0.05) than their American counterparts. Underweight Chinese patients (BMI <18.5) had higher modified total Sharp scores (median 17 10) and joint space narrowing (JSN) subscores (median 6 2) (both < 0.05) than normal-weight patients (BMI ≥18.5-<24). After controlling for confounding, continuous BMI was cross-sectionally negatively associated with RJD [adjusted prevalence odds ratio (OR) 0.90 (95% CI 0.85, 0.96)] and JSN [adjusted prevalence OR 0.92 (95% CI 0.87, 0.96)]; being underweight normal weight was associated with RJD [adjusted prevalence OR 2.14 (95% CI 1.37, 3.35)] and JSN [adjusted prevalence OR 1.77 (95% CI 1.10, 2.84)].
Low BMI and being underweight were cross-sectionally associated with joint damage in Chinese RA patients, especially JSN, suggesting the clinical importance of identifying underweight patients and focusing on weight gain to prevent joint damage.
描述中国类风湿关节炎（RA）患者与美国患者的体重指数（BMI）特征，并研究其与中国患者关节损伤的关联。
对来自中国真实世界RA人群的1318例患者，首先按性别分层，然后将每位患者与1999 - 2018年美国国家健康与营养检查调查中的1例美国RA患者进行个体年龄匹配。收集了入组时的BMI、双手X线片及危险因素数据，但美国患者没有X线片。采用逻辑回归评估中国患者中BMI与影像学关节损伤（RJD）的关联。
中国患者的BMI显著低于美国患者[（加权）中位数21.8对29.8kg/m²；P<0.001]，体重过低的患病率更高（15.2%对1.1%；P<0.05）。体重过低的中国患者（BMI<18.5）的改良总Sharp评分（中位数17对10）和关节间隙狭窄（JSN）子评分（中位数6对2）均高于正常体重患者（BMI≥18.5 - <24）（均P<0.05）。在控制混杂因素后，连续BMI与RJD呈横断面负相关[调整后的患病率比值比（OR）0.90（95%CI 0.85，0.96）]和JSN[调整后的患病率OR 0.92（95%CI 0.87，0.96）]；体重过低与正常体重相比与RJD[调整后的患病率OR 2.14（95%CI 1.37，3.35）]和JSN[调整后的患病率OR 1.77（95%CI 1.10，2.84）]相关。
在中国RA患者中，低BMI和体重过低与关节损伤呈横断面关联，尤其是JSN，提示识别体重过低患者并关注体重增加以预防关节损伤的临床重要性。
