Lee Jung Sun, Oh Ji Seon, Kim Sehee, Kim Ye-Jee, Hong Seokchan, Kim Yong-Gil, Lee Chang-Keun, Yoo Bin
Division of Rheumatology, Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea.
Department of Information Medicine, Asan Medical Center, Seoul, Korea.
Rheumatol Int. 2024 Dec;44(12):2863-2871. doi: 10.1007/s00296-024-05748-5. Epub 2024 Nov 22.
This study aimed to assess the association between obesity or changes in body mass index (BMI) and the risk of RA considering the abdominal obesity status.
We included individuals aged 23 to 60 who underwent a national health examination in 2012-2013 (baseline) and four years prior. Obesity was defined by a BMI ≥ 25 kg/m. The change in BMI over 4 years was divided into quartiles. Cox proportional hazard analysis was performed to assess the association of obesity and BMI change with the risk of RA.
A total of 6,207,246 subjects were included, and 7,859 incident cases of RA were identified. Obesity was associated with a reduced risk of RA in males (HR 0.78, 95% CI 0.71-0.85) and females (HR 0.91, 95% CI 0.85-0.97). In subgroup analysis according to abdominal obesity status, the associations were observed for obesity with normal waist circumference (WC) in males (HR 0.75, 95% CI 0.67-0.84) and females (HR 0.88, 95% CI 0.81-0.95). In terms of BMI change, compared to the stable BMI group (quartile 2), the third (HR 0.92, CI 0.85-0.99) and highest quartile (HR 0.89, CI 0.83-0.96) showed an inverse association with the risk of RA in females, particularly in those with normal WC.
Obesity was associated with a lower risk of RA, especially among individuals with a normal WC. Increased BMI was also associated with a lower risk of RA, but this association was mainly observed in females and specifically for those with normal WC.
本研究旨在考虑腹部肥胖状况，评估肥胖或体重指数（BMI）变化与类风湿关节炎（RA）风险之间的关联。
我们纳入了2012 - 2013年（基线）及四年前接受全国健康检查的23至60岁个体。肥胖定义为BMI≥25kg/m²。4年期间BMI的变化分为四分位数。采用Cox比例风险分析评估肥胖和BMI变化与RA风险的关联。
共纳入6,207,246名受试者，确定了7859例RA新发病例。肥胖与男性（风险比[HR]0.78，95%置信区间[CI]0.71 - 0.85）和女性（HR 0.91，95% CI 0.85 - 0.97）的RA风险降低相关。在根据腹部肥胖状况进行的亚组分析中，男性（HR 0.75，95% CI 0.67 - 0.84）和女性（HR 0.88，95% CI 0.81 - 0.95）中，正常腰围（WC）的肥胖与RA风险存在关联。就BMI变化而言，与稳定BMI组（四分位数2）相比，第三（HR 0.92，CI 0.85 - 0.99）和最高四分位数（HR 0.89，CI 0.83 - 0.96）与女性RA风险呈负相关，尤其是WC正常的女性。
肥胖与较低的RA风险相关，尤其是在WC正常的个体中。BMI增加也与较低的RA风险相关，但这种关联主要见于女性，尤其是WC正常的女性。
