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Impact of obesity on functioning among women with systemic lupus erythematosus.

Abstract

OBJECTIVE

Obesity is associated with high rates of disability in the general population. The nature of the relationship between obesity and disability in systemic lupus erythematosus (SLE), a condition with a high background rate of disability, is unknown.

METHODS

Data were from 2 interviews, 4 years apart, of a longitudinal cohort of individuals with SLE (n = 716 women). Body mass index (BMI) was calculated from self-reported height and weight; obesity was classified by usual (BMI ≥30) and revised (BMI ≥26.8) definitions. Three measures of functioning were examined: the Short Form 36 (SF-36) Health Survey physical function (PF) subscale, Valued Life Activities (VLA) Disability Questionnaire, and employment. Multivariate analyses controlled for demographics, SLE duration and disease activity, glucocorticoid use, depression, and comorbidities. Prospective analyses also controlled for baseline function.

RESULTS

At a BMI of ≥30, 27.8% of the subjects were obese; at a BMI of ≥26.8, 40.6% of the subjects were obese. Regardless of obesity definition, obese women exhibited poorer baseline function, with decrements ranging from 20-33% depending on the functional measure and obesity definition. With a BMI of ≥26.8, the adjusted SF-36 PF scores were 4.3 points lower for obese women (P < 0.0001), VLA difficulty was 0.09 higher (P = 0.01), and odds of employment were 80% of nonobese women (odds ratio 0.8, 95% confidence interval 0.5-1.1). At the 4-year followup, women who were obese at baseline had poorer function and experienced greater functional declines.

CONCLUSION

Obesity was associated with clinically significant negative effects on function, both concurrently and prospectively. This negative impact occurred at a lower BMI than is often considered problematic clinically. Because of the high rate of SLE-related disability, addressing preventable risk factors such as obesity may improve long-term SLE outcomes.

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  • Authors+Show Affiliations

    ,

    Arthritis Research Group, University of California, San Francisco, 94143, USA. patti.katz@ucsf.edu

    , , , , ,

    Source

    Arthritis care & research 63:10 2011 Oct pg 1357-64

    MeSH

    Activities of Daily Living
    Adult
    Body Mass Index
    Chi-Square Distribution
    Comorbidity
    Disability Evaluation
    Disease Progression
    Employment
    Female
    Health Status
    Humans
    Interviews as Topic
    Linear Models
    Logistic Models
    Longitudinal Studies
    Lupus Erythematosus, Systemic
    Middle Aged
    Obesity
    Prospective Studies
    Risk Assessment
    Risk Factors
    San Francisco
    Surveys and Questionnaires
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    21702085

    Citation

    Katz, Patricia, et al. "Impact of Obesity On Functioning Among Women With Systemic Lupus Erythematosus." Arthritis Care & Research, vol. 63, no. 10, 2011, pp. 1357-64.
    Katz P, Yazdany J, Julian L, et al. Impact of obesity on functioning among women with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2011;63(10):1357-64.
    Katz, P., Yazdany, J., Julian, L., Trupin, L., Margaretten, M., Yelin, E., & Criswell, L. A. (2011). Impact of obesity on functioning among women with systemic lupus erythematosus. Arthritis Care & Research, 63(10), pp. 1357-64. doi:10.1002/acr.20526.
    Katz P, et al. Impact of Obesity On Functioning Among Women With Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). 2011;63(10):1357-64. PubMed PMID: 21702085.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Impact of obesity on functioning among women with systemic lupus erythematosus. AU - Katz,Patricia, AU - Yazdany,Jinoos, AU - Julian,Laura, AU - Trupin,Laura, AU - Margaretten,Mary, AU - Yelin,Edward, AU - Criswell,Lindsey A, PY - 2011/6/25/entrez PY - 2011/6/28/pubmed PY - 2011/12/13/medline SP - 1357 EP - 64 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 63 IS - 10 N2 - OBJECTIVE: Obesity is associated with high rates of disability in the general population. The nature of the relationship between obesity and disability in systemic lupus erythematosus (SLE), a condition with a high background rate of disability, is unknown. METHODS: Data were from 2 interviews, 4 years apart, of a longitudinal cohort of individuals with SLE (n = 716 women). Body mass index (BMI) was calculated from self-reported height and weight; obesity was classified by usual (BMI ≥30) and revised (BMI ≥26.8) definitions. Three measures of functioning were examined: the Short Form 36 (SF-36) Health Survey physical function (PF) subscale, Valued Life Activities (VLA) Disability Questionnaire, and employment. Multivariate analyses controlled for demographics, SLE duration and disease activity, glucocorticoid use, depression, and comorbidities. Prospective analyses also controlled for baseline function. RESULTS: At a BMI of ≥30, 27.8% of the subjects were obese; at a BMI of ≥26.8, 40.6% of the subjects were obese. Regardless of obesity definition, obese women exhibited poorer baseline function, with decrements ranging from 20-33% depending on the functional measure and obesity definition. With a BMI of ≥26.8, the adjusted SF-36 PF scores were 4.3 points lower for obese women (P < 0.0001), VLA difficulty was 0.09 higher (P = 0.01), and odds of employment were 80% of nonobese women (odds ratio 0.8, 95% confidence interval 0.5-1.1). At the 4-year followup, women who were obese at baseline had poorer function and experienced greater functional declines. CONCLUSION: Obesity was associated with clinically significant negative effects on function, both concurrently and prospectively. This negative impact occurred at a lower BMI than is often considered problematic clinically. Because of the high rate of SLE-related disability, addressing preventable risk factors such as obesity may improve long-term SLE outcomes. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/21702085/full_citation L2 - https://doi.org/10.1002/acr.20526 DB - PRIME DP - Unbound Medicine ER -