General Medicine

Low Income Linked to Comorbidities in Rheumatoid Arthritis

Avatar photoHannah Dellabella
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The rheumatoid nodule is the most common cutaneous and extraarticular manifestation of RA. Though most coRA nommonly found on pressure points such as on the olecranon process, they can also occur at other sites. Subcutaneous nodules are located proximally to joints, are firm to palpation, and usually are noted to have overlying intact skin. Histologically, rheumatoid nodules are characterized by a central area of necrosis with concentric layers of macrophages and lymphocytes.
The rheumatoid nodule is the most common cutaneous and extraarticular manifestation of RA. Though most coRA nommonly found on pressure points such as on the olecranon process, they can also occur at other sites. Subcutaneous nodules are located proximally to joints, are firm to palpation, and usually are noted to have overlying intact skin. Histologically, rheumatoid nodules are characterized by a central area of necrosis with concentric layers of macrophages and lymphocytes.
Researchers in Korea found data showing that low socioeconomic status in patients with rheumatoid arthritis who were aged 63 years or younger were more susceptible to cardiometabolic risk factors and musculoskeletal disease.

For patients with rheumatoid arthritis (RA) aged <63 years, socioeconomic status (SES) is associated with multiple comorbidities in mental, cardiometabolic, and musculoskeletal systems, according to results published in Rheumatology.

The study included participants with RA from the 2007 to 2015 Korea National Health and Nutrition Examination Survey database (n=1088). The researchers collected SES data on household equivalence income, education, and area of residence. Participants were stratified by median age (63 years) to minimize confounding. The researchers estimated age-adjusted odds ratio (OR), comparing weighted prevalence of comorbidities between low- and high SES groups.

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Among participants aged <63 years (mean, 49 years), the researchers found that depression (OR, 2.13; 95% CI, 1.01-4.53), depressive mood (OR, 2.68; 95% CI, 1.54-4.65), suicide ideation (OR, 3.01; 95% CI, 1.79-5.07), diabetes (OR, 3.09; 95% CI, 1.31-7.29), obesity (OR, 2.04; 95% CI, 1.30-3.20), hypertriglyceridemia (OR, 2.36; 95% CI, 1.28-4.34), and osteoarthritis (OR, 2.12; 95% CI, 1.13-3.99) were associated with low income.

They also found that suicide ideation was associated with low education level (OR, 2.25; 95% CI, 1.14-4.44). The results did not indicate any associations between comorbidities and area of residence.

The low SES group had a numerically higher rate of failed access to necessary medical services (23.8%) compared with the high SES groups (18.1%). Among participants aged ≥63 years (mean, 72 years), the researchers did not find any associations between SES and comorbidities.

“Acknowledging different risks of comorbidities according to SES would be essential to provide optimal care and to improve health outcomes in patients with RA,” the researchers wrote.

Reference

Shin A, Shin S, Kim JH, et al. Association between socioeconomic status and comorbidities among patients with rheumatoid arthritis: results of a nationwide cross-sectional survey [published online March 19, 2019]. Rheumatology. doi:10.1093/rheumatology/kez081

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