Dong Yuanyuan, Greenwood Darren C, Hardie Laura J, Cade Janet E
Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK.
Leeds Institute for Data Analytics, Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.
Nutrients. 2025 Apr 30;17(9):1557. doi: 10.3390/nu17091557.
: To estimate the association between various indicators of obesity-related health risk and the incidence of rheumatoid arthritis (RA) in a large cohort of women. : The UK Women's Cohort Study is a prospective cohort of 35,372 middle-aged women (aged 35-69 at recruitment) initiated in 1995-1998. Obesity was assessed using body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), categorised according to WHO and NICE guidelines, as well as clothing size. Incident RA cases were identified via Hospital Episode Statistics (HES) linkage up to March 2019. Cox regression models were used to estimate RA risk, adjusting for demographics, reproductive factors, and lifestyle factors. Non-linear associations were examined using restricted cubic splines. : Among 27,968 eligible subjects with complete data linkage (625,269 person-years of follow-up), there were 255 incident RA cases. Obesity (≥30.0 kg/m) was associated with increased RA risk (HR (95% CI) 1.48 (1.02, 2.17), as were abdominal obesity (WC > 88 cm: 1.58 (1.10, 2.27)), WHR ≥ 0.85 (1.56 (1.03, 2.36)), and WHtR ≥ 0.6 (2.25 (1.34, 3.80)). Each 2.5 kg/m increase in BMI was associated with a 9% higher risk of RA; each 5 cm increase in WC with 6%; each 0.1 increase in WHR with 20%, and each 0.1 increase in WHtR with 27%. Larger clothing sizes were associated with a greater RA risk: for each onesize increment in blouse size and skirt size, the HRs were 1.13 (95% CI: 1.04, 1.22) and 1.13 (95% CI: 1.05, 1.22), respectively. Notably, skirt size ≥ 20 was associated with a 2.36-fold increased risk of RA. There was evidence of effect modification by weight change and menopausal status in obesity-related RA risk. : Our findings suggest that managing obesity and central adiposity in middle-aged women may be associated with the risk of developing RA. WHtR may serve as a practical alternative to BMI in assessing RA risk. Clothing size, particularly skirt size, could provide a simple, cost-effective proxy for identifying at high risk of RA.
为评估一大群女性中与肥胖相关的健康风险的各种指标与类风湿性关节炎（RA）发病率之间的关联。：英国女性队列研究是一项前瞻性队列研究，始于1995 - 1998年，共有35372名中年女性（招募时年龄在35 - 69岁）。使用体重指数（BMI）、腰围（WC）、腰臀比（WHR）、腰高比（WHtR）根据世界卫生组织（WHO）和英国国家卫生与临床优化研究所（NICE）指南进行分类评估肥胖情况，同时也考虑服装尺寸。通过与医院 Episode Statistics（HES）数据库关联，确定截至2019年3月的RA新发病例。使用Cox回归模型估计RA风险，并对人口统计学、生殖因素和生活方式因素进行调整。使用受限立方样条检验非线性关联。：在27968名有完整数据关联的合格受试者中（随访625269人年），有255例RA新发病例。肥胖（BMI≥30.0 kg/m²）与RA风险增加相关（HR（95%CI）1.48（1.02，2.17）），腹部肥胖（WC > 88 cm：1.58（1.10，2.27））、WHR≥0.85（1.56（1.03，2.36））和WHtR≥0.6（2.25（1.34，3.80））也与RA风险增加相关。BMI每增加2.5 kg/m²，RA风险增加9%；WC每增加5 cm，RA风险增加6%；WHR每增加0.1，RA风险增加20%；WHtR每增加0.1，RA风险增加27%。较大的服装尺寸与更高的RA风险相关：衬衫尺寸和裙子尺寸每增加一个尺码，HR分别为1.13（95%CI：1.04，1.22）和1.13（95%CI：1.05，1.22）。值得注意的是，裙子尺寸≥20与RA风险增加2.36倍相关。有证据表明体重变化和绝经状态对与肥胖相关的RA风险有效应修饰作用。：我们的研究结果表明，控制中年女性的肥胖和中心性肥胖可能与患RA的风险有关。在评估RA风险时，WHtR可能是BMI的一个实用替代指标。服装尺寸，特别是裙子尺寸，可以为识别RA高风险人群提供一种简单、经济有效的替代方法。
