Background: Obesity is at now considered as a mild, long-lasting inflammatory disease associated with an increased cardiovascular (CV) risk. On the other hand, rheumatic diseases have been associated with increased CV risk, and there is an increasing interest regarding the prevalence and the effects of obesity and metabolic syndrome in such patients. Moreover, some rheumatic diseases can induce cachexia or malnutrition, as a consequence of both chronic inflammation or gastrointestinal impairment. Objectives: To evaluate the prevalence of overweight, obesity and metabolic syndrome (MS) in different cohorts of patients affected by the most representative inflammatory, autoimmune and vascular diseases, i.e. Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc). Methods: Body mass index (BMI) was assessed in 564 RA (346 early RA-ERA patients, 218 long standing RA-LSRA with severe disease requiring biologic treatment), 452 SLE patients and 296 SSc patients. BMI was categorized into 3 classes, i.e <25 kg/m2 (normal weight), 25-30 kg/m2 (overweight), and >30 kg/m2 (obese). Underweight patients (BMI<18.5 kg/m2) were also considered. Levels of total cholesterol, HDL-cholesterol, triglycerides, fasting glucose were evaluated, as well as the presence of arterial hypertension and diabetes mellitus. Metabolic syndrome was defined according to the American Heart Association/Updated NCEP criteria (1). We considered central obesityas a BMI>24 kg/m2 for women and BMI>25 kg/m2 for men (2) (data on waist-circumference were not availablefor all patients). Results: In the ERA cohort (76.3% female, age 54.6±14.0, disease duration <12 months, mean 5.8±3.5 months), 48.6% of subjects were normal weight, 39% overweight, 12.4% obese, with a mean BMI of 25.3±4.4, and the prevalence of MS was 25.3%; ten patients (2.3%) were underweight. The LSRA (81.2% female, age 58.6±13.1, disease duration 15.2±10.1) had a mean BMI of 25.1±4.5, 52.3% of patients were normal, 34.9% overweight and 12.8% obese; the MS was present in 27% of subjects; the underweight subjects were 4.1%. SLE patients (90.3% female, age 44.1±14.8 years, disease duration 11.6±8.3 years) had a BMI of 24.0±4.6 and 63% were normal weight, 27% overweight and 10% obese; underweight subjects were 8.9%; the MS was observed in 31.3%. In SSc cohort (88.2% female, age 58.5±14.2 years, disease duration 11.4±8.6 years) the mean BMI was 24.4±4.8 and the prevalence of obesity was 10.4%. 136 SSc patients (46.1%) were normal-weight, 125 (42.2%) were overweight, while only 4 (1.3%) were underweight; the prevalence of metabolic syndrome was 14.2%. Conclusions: Obesity and metabolic syndrome are present in an important percentage of patients and should be taken into account as targets at risk for CV diseases. References: [1]Grundy SM, Circulation2005; 112 (17): 2735–52. [2]McLaughlin T, Ann Int Med 2003; 139: 802-9.
Distribution of body mass index and metabolic syndrome in patients with inflammatory autoimmune diseases from a single italian centre
Gremese E;
2013-01-01
Abstract
Background: Obesity is at now considered as a mild, long-lasting inflammatory disease associated with an increased cardiovascular (CV) risk. On the other hand, rheumatic diseases have been associated with increased CV risk, and there is an increasing interest regarding the prevalence and the effects of obesity and metabolic syndrome in such patients. Moreover, some rheumatic diseases can induce cachexia or malnutrition, as a consequence of both chronic inflammation or gastrointestinal impairment. Objectives: To evaluate the prevalence of overweight, obesity and metabolic syndrome (MS) in different cohorts of patients affected by the most representative inflammatory, autoimmune and vascular diseases, i.e. Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc). Methods: Body mass index (BMI) was assessed in 564 RA (346 early RA-ERA patients, 218 long standing RA-LSRA with severe disease requiring biologic treatment), 452 SLE patients and 296 SSc patients. BMI was categorized into 3 classes, i.e <25 kg/m2 (normal weight), 25-30 kg/m2 (overweight), and >30 kg/m2 (obese). Underweight patients (BMI<18.5 kg/m2) were also considered. Levels of total cholesterol, HDL-cholesterol, triglycerides, fasting glucose were evaluated, as well as the presence of arterial hypertension and diabetes mellitus. Metabolic syndrome was defined according to the American Heart Association/Updated NCEP criteria (1). We considered central obesityas a BMI>24 kg/m2 for women and BMI>25 kg/m2 for men (2) (data on waist-circumference were not availablefor all patients). Results: In the ERA cohort (76.3% female, age 54.6±14.0, disease duration <12 months, mean 5.8±3.5 months), 48.6% of subjects were normal weight, 39% overweight, 12.4% obese, with a mean BMI of 25.3±4.4, and the prevalence of MS was 25.3%; ten patients (2.3%) were underweight. The LSRA (81.2% female, age 58.6±13.1, disease duration 15.2±10.1) had a mean BMI of 25.1±4.5, 52.3% of patients were normal, 34.9% overweight and 12.8% obese; the MS was present in 27% of subjects; the underweight subjects were 4.1%. SLE patients (90.3% female, age 44.1±14.8 years, disease duration 11.6±8.3 years) had a BMI of 24.0±4.6 and 63% were normal weight, 27% overweight and 10% obese; underweight subjects were 8.9%; the MS was observed in 31.3%. In SSc cohort (88.2% female, age 58.5±14.2 years, disease duration 11.4±8.6 years) the mean BMI was 24.4±4.8 and the prevalence of obesity was 10.4%. 136 SSc patients (46.1%) were normal-weight, 125 (42.2%) were overweight, while only 4 (1.3%) were underweight; the prevalence of metabolic syndrome was 14.2%. Conclusions: Obesity and metabolic syndrome are present in an important percentage of patients and should be taken into account as targets at risk for CV diseases. References: [1]Grundy SM, Circulation2005; 112 (17): 2735–52. [2]McLaughlin T, Ann Int Med 2003; 139: 802-9.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
