Obesity is an independent contributor to functional capacity and inflammation in systemic lupus erythematosus.
OBJECTIVE
Obesity induces a proinflammatory state and is a major cause of morbidity in the general population. However, little is known about the effects of obesity in patients with chronic inflammatory illnesses such as systemic lupus erythematosus (SLE).


METHODS
One hundred consecutive patients with SLE were studied to determine the relationship between body mass index (BMI) and functional capacity, measures of fatigue, quality of life, and the inflammation markers C-reactive protein (CRP), the erythrocyte sedimentation rate, and interleukin-6 (IL-6). The association between BMI and patient characteristics was determined, and multiple logistic regression models were used to adjust for age, sex, disease activity, and disease-related damage.


RESULTS
Thirty-three patients had a normal BMI (< 25 kg/m(2)), 28 were overweight (25-29.9 kg/m(2)), and 39 were obese (> or =30 kg/m(2)). Obese patients had worse functional capacity, more fatigue, and higher concentrations of inflammation markers. The mean +/- SD modified Health Assessment Questionnaire (M-HAQ) score was 0.6 +/- 0.4 in obese patients compared with 0.3 +/- 0.4 and 0.2 +/- 0.3 in overweight patients and those with a normal BMI, respectively (P = 0.001). The mean +/- SD concentrations of CRP in obese patients (10.0 +/- 8.6 mg/liter) were higher than those in patients who were overweight (4.7 +/- 5.4 mg/liter) or had a normal BMI (6.2 +/- 9.9 mg/liter) (P < 0.001). Similarly, concentrations of IL-6 were higher in obese patients (P = 0.003). After adjusting for age, sex, disease activity, and damage indices, the associations between BMI and CRP (P < 0.001), M-HAQ scores (P = 0.005), and IL-6 concentrations (P = 0.01) remained significant.


CONCLUSIONS
Obesity is independently associated with impaired functional capacity and inflammation markers in patients with lupus. Thus, weight loss may improve functional capacity and decrease cardiovascular risk factors.
Oeser
Annette
A
Vanderbilt University School of Medicine, 23rd Avenue South at Pierce Avenue, Nashville, TN 37232-6602, USA.
Chung
Cecilia P
CP
Asanuma
Yu
Y
Avalos
Ingrid
I
Stein
C Michael
CM
D000203:Activities of Daily Living; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001799:Blood Sedimentation; D015992:Body Mass Index; D002097:C-Reactive Protein; D015897:Comorbidity; D005221:Fatigue; D005260:Female; D006304:Health Status; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D016015:Logistic Models; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013714:Tennessee / Q000453:epidemiology
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein