Lower All-Cause, Cardio Mortality in Obese With RA

But substantially increased risks of comorbidities, total joint replacement, and greater pain

WEDNESDAY, May 2 (HealthDay News) -- Overweight and obese patients with rheumatoid arthritis (RA) have lower all-cause and cardiovascular mortality, but have substantially increased risks of comorbidities, medical costs, and reduced quality of life compared with normal-weight RA patients, according to a study published online April 18 in Arthritis Care & Research.

Frederick Wolfe, M.D., of the National Data Bank for Rheumatic Diseases in Wichita, Kan., and Kaleb Michaud, Ph.D., of the University of Nebraska Medical Center in Omaha, conducted a 12.3-year study of 24,535 patients with RA to study the effect of body mass index (BMI) on mortality and clinical status. Patients were stratified according to age and by BMI (<18.5 kg/m² [underweight], 18.5 to <25 kg/m² [normal], 25 to <30 kg/m² [overweight], and ≥30 kg/m² [obese]).

The researchers found that all-cause and cardiovascular mortality were reduced for overweight and obese patients, with and without adjustment for confounders, while underweight patients had nearly double the mortality risk. However, compared with normal-weight patients, obese patients had a significantly increased likelihood of diabetes (odds ratio [OR], 4.8), hypertension (OR, 3.4), myocardial infarction (OR, 1.3), joint replacement (OR, 1.4), and work disability (OR, 1.9). Medical costs and pain scores were higher, and quality of life scores were lower for obese versus normal-weight patients.

"Overweight and obesity reduce the relative risk of all-cause and cardiovascular mortality across different [age] groups and durations of RA," the authors conclude.

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