RESEARCH - Radiographic joint damage in early RA is highly dependent on BMI

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Arthritis & Rheumatism

Volume 56, Issue 11, Pages 3575-3582

Published Online: 29 Oct 2007

Rheumatoid Arthritis Clinical Studies

Radiographic joint damage in early rheumatoid arthritis is highly

dependent on body mass index

Gisela Westhoff 1 *, Rolf Rau 2, Zink 1

1German Rheumatism Research Centre, Berlin, Germany

2Evangelisches Fachkrankenhaus Ratingen, Ratingen, Germany

Abstract

Objective

To investigate the association between body mass index (BMI) and

radiographic joint damage (using the Ratingen Score [RS]) in early

rheumatoid arthritis (RA).

Methods

The study was carried out in 767 patients with early RA. Standard

clinical data, RS, and BMI were evaluated at baseline and after 3

years. Multivariate logistic regression analyses were performed in

rheumatoid factor (RF)-positive and RF-negative patients to determine

the influence of BMI (<25 versus 30 kg/m2) on considerable joint

damage (RS 7) after 3 years, adjusting for sex, age, disease duration,

and disease activity (using the Disease Activity Scale in 28 joints

[DAS28]).

Results

Patients of normal weight already had significantly more joint damage

at study entry than obese patients (mean RS 4.5 versus 2.4; P = 0.004)

and experienced significantly more progression than obese patients (RS

3.4 versus 1.3; P = 0.011). At 3 years, their RS score was twice as

high as that of the obese patients (7.5 versus 3.7; P < 0.001).

Multivariate regression analyses in both serologic groups revealed

significantly higher odds of RS 7 in RF-positive patients of normal

weight than in RF-positive obese patients (odds ratio [OR] 3.3), but

not in RF-negative patients. Male sex (OR 1.6), osteoporosis (OR 2.0),

C-reactive protein levels >15 mg/liter versus <5 mg/liter (OR 2.6),

and disease activity (DAS28 5.1 versus <3.2; OR 1.9) were

independently associated with RS 7.

Conclusion

BMI provides a risk estimate of joint damage in RA patients. Further

studies are needed to elucidate the association between BMI, RF, and

joint damage in RA and the possible role of adipose tissue.

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