Salehi Tania, French Thomas, Farrah Tariq E, Hunter Robert W
Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, Scotland.
Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia.
Rheumatol Adv Pract. 2025 Aug 9;9(3):rkaf088. doi: 10.1093/rap/rkaf088. eCollection 2025.
The prevalence of obesity in ANCA-associated vasculitis (AAV) has not been well documented, despite an increased risk of cardiometabolic disease in these patients. We aimed to characterize changes in weight following a diagnosis of AAV and determine risk factors for gaining weight and becoming obese.
We examined data from a single-centre registry of patients with AAV, diagnosed between 2003 and 2023. We evaluated changes in weight and BMI following diagnosis and determined the prevalence of obesity. Using linear regression, we identified factors contributing to an increase in BMI at 6 months. Logistic regression was used to define predictors for obesity at 6 months.
A total of 215 patients with AAV were included. Patients experienced a mean weight gain of 5.2% in the first 6 months; this was sustained for at least 2 years. A total of 69% of patients were overweight or obese at 6 months compared with 59% at baseline. Weight gain was greater following the first presentation compared with relapsing disease. Baseline factors associated with an increase in BMI at 6 months included higher eGFR [β = 0.70 (95% CI 0.36, 1.03), < 0.001] and earlier year of presentation [β = 0.38 (95% CI 0.08, 0.69), = 0.008]. Higher eGFR [adjusted odds ratio (aOR) 1.36 (95% CI 1.08, 2.72), < 0.001] and baseline BMI [aOR 2.57 (95% CI 1.81, 3.64), < 0.001] were associated with an increased likelihood of obesity at 6 months.
Weight gain is common following a diagnosis of active AAV. This is now less pronounced than it was 2 decades ago. Better kidney function and higher baseline BMI are associated with a greater risk of being obese at 6 months. Many patients with AAV are likely to benefit from interventions aimed at achieving a healthy weight.
尽管抗中性粒细胞胞浆抗体相关性血管炎（AAV）患者发生心脏代谢疾病的风险增加，但其肥胖患病率尚未得到充分记录。我们旨在描述AAV诊断后体重的变化情况，并确定体重增加和肥胖的危险因素。
我们研究了2003年至2023年期间诊断为AAV的单中心登记患者的数据。我们评估了诊断后体重和体重指数（BMI）的变化，并确定了肥胖患病率。使用线性回归，我们确定了6个月时导致BMI增加的因素。逻辑回归用于定义6个月时肥胖的预测因素。
共纳入215例AAV患者。患者在最初6个月内平均体重增加5.2%；这种情况持续了至少2年。6个月时，共有69%的患者超重或肥胖，而基线时这一比例为59%。与复发疾病相比，初次发病后体重增加更为明显。6个月时与BMI增加相关的基线因素包括较高的估算肾小球滤过率（eGFR）[β = 0.70（95%置信区间0.36，~1.03），P < 0.001]和较早的发病年份[β = 0.38（95%置信区间0.08，0.69），P = 0.008]。较高的eGFR[调整优势比（aOR）1.36（95%置信区间1.08，2.72），P < 0.001]和基线BMI[aOR 2.57（95%置信区间1.81，3.64），P < 0.001]与6个月时肥胖可能性增加相关。
活动性AAV诊断后体重增加很常见。现在这种情况比20年前不那么明显了。更好的肾功能和更高的基线BMI与6个月时肥胖风险增加相关。许多AAV患者可能会从旨在实现健康体重的干预措施中受益。
