Obesity Leads to Poor Outcomes for Patients with Systemic Lupus Erythematosus

woman crying who is overweight
woman crying who is overweight
The impact of excess adiposity in SLE has not been established, despite obesity being a common comorbidity in SLE.
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San Diego — Obesity is associated with poor patient outcomes, such as pain, depression, and fatigue, in women with systemic lupus erythematosus (SLE), according to a study presented at the 2017 ACR/ARHP Annual Meeting held November 3-8.

“Obesity has been shown to exacerbate systemic inflammation in the general population and contributes to worse disease-related outcomes in rheumatoid arthritis,” said investigator Sarah L. Patterson, MD, from the University of California in San Francisco, and colleagues. “The impact of excess adiposity in SLE has not been established despite obesity being a common comorbidity in SLE.”

Investigators reviewed patient data from the ABCD (Arthritis Body Composition and Disability) study to evaluate outcomes in obese women with a diagnosis of SLE (n=148). The 2 definitions for obesity used in the study were: fat mass index (FMI) ≥13 kg/m2 and body mass index (BMI) ≥30 kg/m2.

Assessed outcomes included depressive symptoms, disease activity, pain, and fatigue. These outcomes were assessed via the Center for Epidemiologic Studies Depression Scale (CES-D), Systemic Lupus Activity Questionnaire (SLAQ), Short Form 36 Health Survey (SF-36) Pain Subscale, and SF-36 Vitality Subscale.

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Following multivariate regression analysis, the investigators found that obesity correlated with worse scores in all outcome assessments when compared with non-obese participants. Score differences between obese and non-obese patients were found to be statistically significant for disease activity (14.8 vs 11.5; P =.010), depression (19.8 vs 13.1; P =.004), pain (38.7 vs 44.2; P =.004), and fatigue (39.6 vs 45.2; P =.010). (Higher scores for pain and fatigue reflect better status [ie, less pain and less fatigue].)

Researchers also found that the same relationship between obesity and each patient-reported outcome existed following repeat analyses with the BMI cut-off point of ≥30 kg/m2.

The findings demonstrated that the presence of obesity “may represent a modifiable target for improving outcomes” in women with SLE.

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Patterson SL, Schmajuk G, Jafri K, Wysham KD, Katz PP. Obesity independently associates with worse patient reported outcomes in women with systemic lupus erythematosus. Presented at: ACR/ARHP 2017 Annual Meeting; November 3-8, 2017; San Diego, California. Abstract 2263.