Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis
Metsios, Giorgos S.
Panoulas, Vasileios F.
Douglas, Karen M. J.
Nevill, Alan M.
Jamurtas, Athanasios Z.
Kita, Marina D.
Kitas, George D.
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AbstractOBJECTIVES: 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.
CitationAnnals of the Rheumatic Diseases, 3 August 2008: online
JournalAnnals of the Rheumatic Diseases
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