- Original article
- Open access
- Published:
Differences in body mass index, waist circumference, and waist-to-hip ratio in patients with rheumatoid arthritis: association with serum adiponectin and disease parameters
Egyptian Rheumatology and Rehabilitation volume 44, pages 24–29 (2017)
Abstract
Objective
The aim of this study was to investigate differences in BMI, waist circumference (WC), and waist-to-hip ratio (WHR) in rheumatoid arthritis (RA) patients and their association with serum adiponectin and disease parameters.
Patients and methods
Fifty RA patients and 25 matched healthy controls were included. Anthropometric measurements, disease status, and serum adiponectin level were assessed.
Results
Out of 50 RA patients, 48% had normal BMI (18.5–24.9 kg/m2), 20% had BMI in the range of 25.0–29.9 kg/m2, which is considered to be overweight, and 32% were obese, with BMI greater than 30 kg/m2. Almost similar findings were observed by the measurements of WC− that is, 34% of patients were obese ‘abdominal obesity’. However, the percentage of obese patients increased to 42% when classified as per WHR ‘truncal obesity’. Serum adiponectin was significantly increased in RA patients compared with controls (P=0.002). Significant negative correlations of BMI and WC with serum adiponectin level were found (r=−0.9, P≤0.001; r=−0.7, P≤0.001, respectively). There were positive correlations of WHR with Disease Activity Score 28 (r=0.3, P=0.047), Multidimensional Health Assessment Questionnaire (r=0.3, P=0.04), and ultrasound Disease Activity Score (r=0.4, P=0.04), whereas there was a significant negative correlation with ultrasound erosion rate (r=−0.3, P=0.02).
Conclusion
BMI, WC, and WHR measurements should be used and encouraged in the RA population. Our findings suggested that WHR was better associated with disease activity, disability, and severity than with other measures.
References
MacGregor AJ, Silman AJ. Classification and epidemiology. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, editors. Rheumatology. 4th ed. Philadelphia, PA: Mosby Elsevier; 2008. 1211–1216.
Summers G, Metsios G, Stavropoulos-Kalinoglou A, Kitas GD. Rheumatoid cachexia and cardiovascular disease. Nat Rev Rheumatol 2010; 6:445–451.
Westhoff G, Rau R, Zink A. Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis Rheum 2007; 56:3575–3582.
Stavropoulos-Kalinoglou A, Metsios G, Koutedakis Y, Kitas GD. Obesity in rheumatoid arthritis. Rheumatology (Oxford) 2011; 50:450–462.
Frommer K, Zimmermann B, Meier F, Schröder D, Heil M, Schäffler A, et al. Adiponectin-mediated changes in effector cells involved in the pathophysiology of rheumatoid arthritis. Arthritis Rheum 2010; 62:2886–2899.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31:315–324.
WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363:157–163.
World Health Organization. Obesity preventing and managing the Global Epidemic: Report of a WHO consultation on obesity. Geneva: World Health Organization 1998.
Prevoo ML, Van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995; 38:44–48.
Pincus T, Swearingen C, Wolfe F. Toward a multidimensional Health Assessment Questionnaire (MDHAQ): assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis Rheum 1999; 42:2220–2230.
Van der Heijde D, Boers M, Lassere M. Methodological issues in radiographic scoring methods in rheumatoid arthritis. J Rheumatol 1999; 26:726–730.
Szkudlarek M, Court-Payen M, Jacobsen S, Klarlund M, Thomsen HS, Østergaard M. Interobserver agreement in ultrasonography of the finger and toe joints in rheumatoid arthritis. Arthritis Rheum 2003; 48:955–962.
Watanabe S, Okura T, Kurata M, Irita J, Manabe S, Miyoshi K, et al. The effect of losartan and amlodipine on serum adiponectin in Japanese adults with essential hypertension. Clin Ther 2006; 28:1677–1685.
Naranjo A, Sokka T, Descalzo MA, Calvo-Alén J, Hørslev-Petersen K, Luukkainen RK, et al. QUEST-RA Group. Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study. Arthritis Res Ther 2008; 10:R30.
Armstrong DJ, McCausland EM, Quinn AD, Wright GD. Obesity and cardiovascular risk factors in rheumatoid arthritis. Rheumatology 2006; 45:782–783.
Mattsson S, Thomas BJ. Development of methods for body composition studies. Phys Med Biol 2006; 51:R203–R228.
Stavropoulos-Kalinoglou A, Metsios GS, Koutedakis Y, Nevill AM, Douglas KM, Jamurtas A, et al. Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis 2007; 66:1316–1321.
Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004; 79:379–384.
Alberti KGM, Zimmet P, Shaw J. The metabolic syndrome a new worldwide definition. Lancet 2005; 366:1059–1062.
Lee JS, Aoki K, Kawakubo K, Gunji A. A study on indices of body fat distribution for screening for obesity. J Occup Health 1995; 37:9–18.
Senolt L, Pavelka K, Housa D, Haluzik M. Increased adiponectin is negatively linked to the local inflammatory process in patients with rheumatoid arthritis. Cytokine 2006; 35:247–252.
Ebina K, Fukuhara A, Ando W, Hirao M, Koga T, Oshima K, et al. Serum adiponectin concentrations correlate with severity of rheumatoid arthritis evaluated by extent of joint destruction. Clin Rheumatol 2009; 28: 445–451.
Giles JT, Allison M, Bingham CO3rd, Scott WM Jr, Bathon JM. Adiponectin is a mediator of the inverse association of adiposity with radiographic damage in rheumatoid arthritis. Arthritis Rheum 2009; 61:1248–1256.
Laurberg TB, Frystyk J, Ellingsen T, Hansen IT, Jørgensen A, Tarp U, et al. Plasma adiponectin in patients with active, early, and chronic rheumatoid arthritis who are steroid and disease modifying anti-rheumatic drug-naive compared with patients with osteoarthritis and controls. J Rheumatol 2009; 36:1885–1891.
Fagerer N, Kullich W. Adipocytokines in rheumatoid arthritis and obesity. Wien Med Wochenschr 2010; 160:391–398.
Oranskiy SP, Yeliseyeva LN, Tsanaeva AV, Zaytseva NV. Body composition and serum levels of adiponectin, vascular endothelial growth factor, and interleukin-6 in patients with rheumatoid arthritis. Croat Med J 2012; 53:350–356.
Baker JF, George M, Baker DG, Toedter G, Von Feldt JM, Leonard MB. Associations between body mass, radiographic joint damage, adipokines and risk factors for bone loss in rheumatoid arthritis. Rheumatology (Oxford) 2011; 50:2100–2107.
Ajeganova S, Andersson M, Hafström I BARFOT Study Group. Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: a long-term follow up from disease onset. Arthritis Care Res (Hoboken) 2013; 65:78–87.
Jurgens MS, Jacobs JW, Geenen R, Bossema ER, Bakker MF, Bijlsma JW, et al. Utrecht Arthritis Cohort Study Group. Increase of body mass index in a tight controlled methotrexate-based strategy with prednisone in early rheumatoid arthritis: side-effect of the prednisone or better control of disease activity?. Arthritis Care Res (Hoboken) 2013; 65:88–93.
Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF, Nevill AM, Jamurtas AZ, Koutedakis Y, et al. Underweight and obese states both associate with worse disease activity and physical function in patients with established rheumatoid arthritis. Clin Rheumatol 2009; 28:439–444.
Ibn Yacoub Y, Amine B, Laatiris A, Wafki F, Znat F, Hajjaj-Hassouni N. Prevalence of overweight in Moroccan patients with rheumatoid arthritis and its relationships with disease features. Clin Rheumatol 2012; 31: 479–482.
Jawaheer D, Olsen J, Lahiff M, Forsberg S, Lähteenmäki J, da Silveira IG, et al. QUEST-RA. Gender, body mass index and rheumatoid arthritis disease activity: results from the QUEST-RA Study. Clin Exp Rheumatol 2010; 28:454–461.
van der Helm-van Mil AH, van der Kooij SM, Allaart CF, Toes RE, Huizinga TW. A high body mass index is protective on the amount of joint destruction in small joints in early rheumatoid arthritis. Ann Rheum Dis 2008; 67: 769–774.
Kaufmann J, Kielstein V, Kilian S, Stein G, Hein G. Relation between body mass index and radiological progression in patients with rheumatoid arthritis. J Rheumatol 2003; 30:2350–2355.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Kamel, S.R., Sadek, H.A., Mohamed, F.A. et al. Differences in body mass index, waist circumference, and waist-to-hip ratio in patients with rheumatoid arthritis: association with serum adiponectin and disease parameters. Egypt Rheumatol Rehabil 44, 24–29 (2017). https://doi.org/10.4103/1110-161X.200837
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/1110-161X.200837