The effect of body mass index on mortality and clinical status in rheumatoid arthritis
Arthritis Care & Research ,

Wolfe F et al. – Overweight and obesity reduce the relative risk (RR) of all–cause and cardiovascular mortality across different ages groups and durations of RA. By contrast, overweight and obesity are associated with substantial increased risks of comorbidity, total joint replacement, greater pain, medical costs and decreased quality of life.

Methods
  • The authors studied mortality in 24,535 patients over 12.3 years, dividing patients into 3 age groups, <50, 50–70, and >70 years and fit Cox regression models separately within each age stratum.
  • They used BMI categories of <18.5 (underweight), 18.5 to <25 (normal weight, reference category), 25 to <30 (overweight), and =30 (obesity).

Results
  • BMI =30 was seen in 63–68% and underweight in ˜2%.
  • Reduction in the RR (95% CI) for all–cause (AC) and cardiovascular mortality was seen for overweight (AC 0.8, 0.8–0.9) and obese groups (AC) 0.8 (0.7, 0.8), with and without comorbidity adjustment.
  • Underweight was associated with increased mortality risk, 1.9, (1.7, 2.3).
  • By contrast, obesity produced profound changes in clinical variables.
  • Compared with normal weight, the odds ratio in the obese group was 4.8 for diabetes, 3.4 for hypertension, 1.3 for myocardial infarction, 1.4 for joint replacement, and 1.9 for work disability.
  • Total semiannual direct medical costs were $1,683 greater, annual household income $6,481 less, pain scores 1.1 units higher, HAQ 0.28 higher, EuroQOL utility 0.7 units lower in the obese.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: Insights from a qualitative substudy Menopause, November 10, 2014    Clinical Article

3 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

4 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

5 Effect of black tea intake on blood cholesterol concentrations in individuals with mild hypercholesterolemia: a diet-controlled randomized trial Journal of the Academy of Nutrition and Dietetics, November 11, 2014    Clinical Article

6 Consumption of garlic and risk of colorectal cancer: An updated meta-analysis of prospective studies Full Text World Journal of Gastroenterology, November 18, 2014    Free full text    Evidence Based Medicine

7 Fiber intake and risk of subsequent prostate cancer in Japanese men American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

8 Associations between the levels of sclerostin, phosphate, and fibroblast growth factor-23 and treatment with vitamin D in hemodialysis patients with low intact PTH level Osteoporosis International, November 10, 2014    Evidence Based Medicine

9 Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women Menopause, November 7, 2014    Clinical Article

10 Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

11 Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review Clinical Nutrition, November 21, 2014    Clinical Article

12 Fruit and vegetable intake and rate of heart failure: A population-based prospective cohort of women European Journal of Heart Failure, November 12, 2014    Clinical Article

13 Effect of low salt diet on insulin resistance in salt-sensitive versus salt-resistant hypertension Hypertension, November 26, 2014    Clinical Article

14 Systemic markers of collagen metabolism and vitamin C in smokers and non-smokers with pelvic organ prolapse European Journal of Obstetrics & Gynecology and Reproductive Biology, November 26, 2014    Clinical Article

15 High-fructose diet in adolescence may exacerbate depressive-like behavior Emory's Woodruff Health Sciences Center News, November 21, 2014

16 Association between fatty acid supplementation and prenatal stress in African Americans: A randomized controlled trial Obstetrics and Gynecology, November 26, 2014    Clinical Article

17 Vegetarian diets and glycemic control in diabetes: A systematic review and meta-analysis Full Text Cardiovascular Diagnosis and Therapy, November 20, 2014    Free full text    Evidence Based Medicine    Review Article

18 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

19 Association between sugar-sweetened beverages and type 2 diabetes: a meta-analysis Journal of Diabetes Investigation, November 13, 2014    Evidence Based Medicine    Review Article

20 Tomato juice consumption improves blood antioxidative biomarkers in overweight and obese females Clinical Nutrition, November 13, 2014    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore