RESEARCH - Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with RA

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Ann Rheum Dis. Published Online First: 3 August 2008.

doi:10.1136/ard.2008.095596

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Concise Report

Associations of obesity with modifiable risk factors for the

development of cardiovascular disease in patients with rheumatoid

arthritis

s Stavropoulos-Kalinoglou 1*, Giorgos S Metsios 1, Vasileios F

Panoulas 2, M J 3, Alan M Nevill 1, Athanasios Z

Jamurtas 4, Marina Kita 3, Yiannis Koutedakis 4 and D Kitas 3

1 University of Wolverhampton, United Kingdom

2 s Hall Hospital, Dudley Group of Hospitals, NHS Trust, United Kingdom

3 Dudley Group of Hospitals, United Kingdom

4 Univeristy of Thessaly, Greece

Abstract

Objectives: To assess the associations of body mass index (BMI) with

modifiable cardiovascular disease (CVD) risk factors in patients with

rheumatoid arthritis (RA).

Methods: BMI, disease activity, selected CVD risk factors and CVD

medication were assessed in 378 (276 females) RA patients. Patients

exceeding accepted thresholds in 3 CVD risk factors were classified as

having the metabolic syndrome (MetS).

Results: BMI independently associated with hypertension (OR=1.28 (95%

CI=1.22-1.34); p=0.001), HDL (OR=1.10 (1.06-1.15); p=0.025), insulin

resistance (OR= 1.13 (1.08-1.18); p=0.000) and the MetS (OR=1.15

(1.08-1.21); p=0.000). In multivariable analyses, BMI had the

strongest associations with CVD risk factors (F1-354=8.663, p=0.000),

and was followed by lipid-lowering treatment (F1-354=7.651, p=0.000),

age (F1-354=7.541, p=0.000), antihypertensive treatment (F1-354=4.997,

p=0.000) and gender (F1-354=4.707, p=0.000). Prevalence of

hypertension (p=0.004), insulin resistance (p=0.005) and the MetS

(p=0.000) was significantly different between normal, overweight and

obese RA patients, and BMI differed significantly according to the

number of risk factors present (p=0.000).

Conclusions: Increasing BMI associates with increased CVD risk

independently of many confounders. RA-specific BMI cut-off points

better identify RA patients at increased CVD risk. Weight-loss regimes

should be developed and applied in order to reduce CVD in RA patients.

http://ard.bmj.com/cgi/content/abstract/ard.2008.095596v1?papetoc

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