Weight Loss, the Obesity Paradox, and the Risk of Death in Rheumatoid Arthritis

Objective In contrast to what is observed in the general population, a low body mass index (BMI) has been associated with accelerated mortality in patients with rheumatoid arthritis (RA). The aim of this study was to assess whether weight loss might explain these seemingly paradoxical observations....

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Veröffentlicht in:Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2015-07, Vol.67 (7), p.1711-1717
Hauptverfasser: Baker, Joshua F., Billig, Erica, Michaud, Kaleb, Ibrahim, Said, Caplan, Liron, Cannon, Grant W., Stokes, Andrew, Majithia, Vikas, Mikuls, Ted R.
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Sprache:eng
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Zusammenfassung:Objective In contrast to what is observed in the general population, a low body mass index (BMI) has been associated with accelerated mortality in patients with rheumatoid arthritis (RA). The aim of this study was to assess whether weight loss might explain these seemingly paradoxical observations. Methods Our study included patients identified from the Veterans Affairs (VA) RA Registry. Dates of death were ed from VA electronic medical records. The BMI at each study visit and the change from the previous visit were determined. The maximum BMI of each patient was also obtained from medical records. The annualized rate of BMI loss was determined from the slope of change (per year) in BMI over visits within the preceding 13 months. Cox multivariable proportional hazards models were used to assess associations between BMI measures and mortality. Results In a sample of 1,674 patients, 312 deaths occurred over 9,183 person‐years. A loss in BMI of ≥1 kg/m2 was associated with a greater risk of death, after adjustment for demographics, comorbidities, BMI, smoking, and RA therapies (hazard ratio [HR] 1.99, 95% confidence interval [95% CI] 1.53–2.59, P 
ISSN:2326-5191
2326-5205
DOI:10.1002/art.39136