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Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis
Stavropoulos-Kalinoglou, Antonios Metsios, Giorgos S. Panoulas, Vasileios F. Douglas, Karen M. J. Nevill, Alan M. Jamurtas, Athanasios Z. Kita, Marina D. Koutedakis, Yiannis Kitas, George D.
Stavropoulos-Kalinoglou, Antonios
Metsios, Giorgos S.
Panoulas, Vasileios F.
Douglas, Karen M. J.
Nevill, Alan M.
Jamurtas, Athanasios Z.
Kita, Marina D.
Koutedakis, Yiannis
Kitas, George D.
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Issue Date
2008
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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.
Citation
Annals of the Rheumatic Diseases, 3 August 2008: online
Publisher
Journal
Research Unit
PubMed ID
18677010
PubMed Central ID
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Type
Journal article
Language
en
Description
Series/Report no.
ISSN
1468-2060