title: Redefining overweight and obesity in rheumatoid arthritis patients.
abstract: OBJECTIVE
  To assess whether body mass index (BMI) and body fat (BF) differ between rheumatoid arthritis (RA) patients, patients with non-inflammatory arthritis (osteoarthritis, OA) and healthy individuals, and whether disease specific measures of adiposity are required to accurately reflect BF in these groups.
  
  
  METHODS
  641 individuals were assessed for BMI (kg/m(2)) and BF (bioelectrical impedance). Of them, 299 (174 RA, 43 OA and 82 healthy controls (HC)) formed the observation group and 342 (all RA) the validation group. RA disease characteristics were collected.
  
  
  RESULTS
  ANOVA revealed significant differences between disease groups for BMI (p<0.05) and BF (p<0.001). ANCOVA showed that age accounted for the differences in BMI (F(1,294) = 5.10, p<0.05); age (F(1,293) = 22.43, p<0.001), sex (F(1,293) = 380.90, p<0.001) and disease (F(2, 293) = 18.7, p<0.001) accounted for the differences in BF. For a given BF, patients with RA exhibited BMI levels reduced by 1.83 kg/m(2) (p<0.001) compared to HC; there were no significant differences between OA and HC. A predictive model for BF was developed (R(2) = 0.769, p<0.001) and validated using limits of agreement Analysis against measured BF in the validation group (95%LIM(AG) = 6.17; CV = 8.94).
  
  
  CONCLUSIONS
  In individuals with RA, BMI cut-off points should be reduced by 2 kg/m(2) (that is, to 23 kg/m(2) for overweight and 28 kg/m(2) for obesity). The equation developed can be used to accurately predict BF from BMI in RA patients. These findings may be important in the context of the cardiovascular comorbidity of RA.
authors.affiliation: Research Institute in Healthcare Science, University of Wolverhampton, Walsall, West Midlands, UK.
authors.forename: Antonios
authors.initials: A
authors.lastname: Stavropoulos-Kalinoglou
authors.forename: Giorgos S
authors.initials: GS
authors.lastname: Metsios
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Koutedakis
authors.forename: Alan M
authors.initials: AM
authors.lastname: Nevill
authors.forename: Karen M
authors.initials: KM
authors.lastname: Douglas
authors.forename: Athanasios
authors.initials: A
authors.lastname: Jamurtas
authors.forename: Jet J C S Veldhuijzen
authors.initials: JJ
authors.lastname: van Zanten
authors.forename: Mourad
authors.initials: M
authors.lastname: Labib
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology; D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis*; D010003:Osteoarthritis / Q000150:complications* / Q000503:physiopathology; D050177:Overweight / Q000502:physiology*; D011237:Predictive Value of Tests; D012737:Sex Factors