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Obesity is Independently Associated With Worse Patient‐Reported Outcomes in Women with Systemic Lupus Erythematosus
Author(s) -
Patterson Sarah L.,
Schmajuk Gabriela,
Jafri Kashif,
Yazdany Jinoos,
Katz Patricia
Publication year - 2019
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.23576
Subject(s) - medicine , body mass index , obesity , confounding , depression (economics) , systemic lupus erythematosus , prospective cohort study , physical therapy , disease , economics , macroeconomics
Objective To determine whether obesity in women with systemic lupus erythematosus ( SLE ) is independently associated with worse patient‐reported outcomes ( PRO s). Methods Data were derived from a prospective study of adult women with a diagnosis of SLE that was verified by medical record review. Two established definitions for obesity were used: fat mass index ( FMI ) ≥13 kg/m 2 and body mass index (BMI) ≥30 kg/m 2 . Dependent variables included 4 validated PRO s: disease activity as assessed by the Systemic Lupus Activity Questionnaire ( SLAQ ), depressive symptoms as assessed by the Center for Epidemiologic Studies Depression Scale ( CES ‐D), pain as assessed by the Short Form 36 ( SF ‐36) pain subscale, and fatigue as assessed by the SF ‐36 vitality subscale. We used multivariable linear regression to evaluate the associations of obesity with PRO s, while controlling for potential confounders (age, race, education, income, smoking, disease duration, disease damage, and prednisone use). Results The analysis included 148 participants, 32% of whom were obese. In the multivariate regression model, obesity was associated with worse scores for each PRO . Mean adjusted scores for the SLAQ and CES ‐D comparing obese versus non‐obese participants were 14.8 versus 11.5 ( P = 0.01) and 19.8 versus 13.1 ( P < 0.01), respectively. The obese group also reported worse mean adjusted scores for pain (38.7 versus 44.2; P < 0.01) and fatigue (39.6 versus 45.2; P = 0.01). Conclusion In a representative sample of women with SLE , obesity (as defined by both FMI and BMI ) was independently associated with worse PRO s, including disease activity, depressive symptoms, and symptoms of pain and fatigue. Obesity may represent a modifiable target for improving outcomes among obese women with SLE .