Obesity May Not Be Associated With Development of Lupus Nephritis

The following article is part of conference coverage from the European League Against Rheumatism (EULAR) Congress 2018 in Amsterdam, The Netherlands. Rheumatology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in rheumatology. Check back for the latest news from EULAR 2018.

Obesity is not associated with the development of lupus nephritis (LN) among patients with systemic lupus erythematosus (SLE), according to findings presented at the European League Against Rheumatism (EULAR) Congress held in Amsterdam, June 13 to 16, 2018.

Investigators conducted a retrospective, cross-sectional study in a longitudinal SLE cohort to explore body mass index (BMI) as a possible predictor for the development of LN in patients with SLE, taking into account prior studies that have indicated that elevated BMI increases an individual’s risk for chronic kidney disease.

Patients were enrolled between 1987 and 2015. Demographics, laboratory findings, and clinical information were compared between patients with and without LN and between patients with SLE with and without obesity. A total of 1362 patients with SLE who met American College of Rheumatology criteria were included in the study. Among 596 participants with biopsy-proven LN, 524 were excluded because of the presence of proteinuria before or at study entry, leaving 72 patients with SLE and LN and 1290 patients with SLE without LN for evaluation.

Only the first available BMI values were analyzed. Of the total participants, 32.7% were considered obese (BMI >30 kg/m²), 27% were overweight (BMI 25-29.9 kg/m²), 37.5% were normal weight (BMI 18.5 to 24.9 kg/m²), and 2.6% were underweight (BMI <18.5 kg/m²). Overall, 39.4% of the participants were taking corticosteroids at their first BMI measurement.

The results of the study showed that after adjusting for age, gender, and ethnicity, BMI measured as continuous (P =.51) and categoric variables (overweight, P =.84; obese, P =.67) were not significantly associated with LN. Patients with SLE and obesity had lower disease activity measured by the Systemic Lupus Erythematosus Disease Activity Index, double-stranded DNA (dsDNA) titers, proteinuria, and higher complement levels.

The investigators concluded that there is no link between obesity and the development of LN among patients with SLE. Study participants with SLE and obesity had lower levels of disease activity, dsDNA titers, and complements levels.

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Reference

Chock YP, Danve A, Petri M, Fu W. Increased body mass index may not be a risk factor for the development of lupus nephritis. Presented at: European League Against Rheumatism (EULAR) Congress 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract AB0538.