TY - JOUR
T1 - Do Obesity and Overweight Influence Disease Activity Measures in Axial Spondyloarthritis? A Systematic Review and Meta-Analysis
AU - Ortolan, Augusta
AU - Lorenzin, Mariagrazia
AU - Felicetti, Mara
AU - Ramonda, Roberta
PY - 2021
Y1 - 2021
N2 - Objective: The aim of our systematic review and meta-analysis was to investigate whether overweight/obesity are associated with higher disease activity measures in patients with axial spondyloarthritis (SpA). Methods: MEDLINE, PubMed, and Web of Science were searched using key terms corresponding to population (axial SpA patients), exposure (overweight/obesity), and outcome (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Ankylosing Spondylitis Disease Activity Score [ASDAS]). Predefined inclusion criteria were adult patients with axial SpA, exposure classified according to body mass index (BMI), BASDAI/ASDAS reported for each BMI group, and observational studies. The Newcastle-Ottawa Scale for cohort, cross-sectional, and case–control studies was used for quality check. Random-effects meta-analysis was used to pool results, which were expressed as the mean difference (MD) in BASDAI and ASDAS between BMI groups, with 95% confidence intervals (95% CIs). Results: A total of 10 articles were included in the meta-analysis. The MD in BASDAI between normal BMI and overweight/obese patients was –0.38 (95% CI –0.56, –0.21; P < 0.0001); the MD in ASDAS between the same groups was –0.19 (95% CI –0.29, –0.09; P < 0.0001). The MD in BASDAI between normal BMI and overweight patients was –0.09 (95% CI –0.33, 0.15; P = 0.45), and the MD between normal BMI and obese patients was –0.78 (95% CI –1.07, –0.48; P < 0.0001). For ASDAS, the MD between normal BMI and overweight patients was –0.02 (95% CI –0.19, 0.15; P = 0.79), and the MD between normal BMI and obese patients was –0.42 (95% CI –0.60, –0.23; P < 0.0001). Conclusion: Overweight and obese patients with axial SpA tend to present higher disease activity scores compared to patients with a normal BMI. This difference seems to be clinically meaningful only for the comparison between obese patients and patients with normal BMI, and more for BASDAI than ASDAS.
AB - Objective: The aim of our systematic review and meta-analysis was to investigate whether overweight/obesity are associated with higher disease activity measures in patients with axial spondyloarthritis (SpA). Methods: MEDLINE, PubMed, and Web of Science were searched using key terms corresponding to population (axial SpA patients), exposure (overweight/obesity), and outcome (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Ankylosing Spondylitis Disease Activity Score [ASDAS]). Predefined inclusion criteria were adult patients with axial SpA, exposure classified according to body mass index (BMI), BASDAI/ASDAS reported for each BMI group, and observational studies. The Newcastle-Ottawa Scale for cohort, cross-sectional, and case–control studies was used for quality check. Random-effects meta-analysis was used to pool results, which were expressed as the mean difference (MD) in BASDAI and ASDAS between BMI groups, with 95% confidence intervals (95% CIs). Results: A total of 10 articles were included in the meta-analysis. The MD in BASDAI between normal BMI and overweight/obese patients was –0.38 (95% CI –0.56, –0.21; P < 0.0001); the MD in ASDAS between the same groups was –0.19 (95% CI –0.29, –0.09; P < 0.0001). The MD in BASDAI between normal BMI and overweight patients was –0.09 (95% CI –0.33, 0.15; P = 0.45), and the MD between normal BMI and obese patients was –0.78 (95% CI –1.07, –0.48; P < 0.0001). For ASDAS, the MD between normal BMI and overweight patients was –0.02 (95% CI –0.19, 0.15; P = 0.79), and the MD between normal BMI and obese patients was –0.42 (95% CI –0.60, –0.23; P < 0.0001). Conclusion: Overweight and obese patients with axial SpA tend to present higher disease activity scores compared to patients with a normal BMI. This difference seems to be clinically meaningful only for the comparison between obese patients and patients with normal BMI, and more for BASDAI than ASDAS.
KW - obesity
KW - obesity
UR - http://hdl.handle.net/10807/305263
U2 - 10.1002/acr.24416
DO - 10.1002/acr.24416
M3 - Article
SN - 2151-464X
VL - 73
SP - 1815
EP - 1825
JO - ARTHRITIS CARE & RESEARCH
JF - ARTHRITIS CARE & RESEARCH
ER -