title: Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the association of body mass index (BMI) with modifiable cardiovascular disease (CVD) risk factors in patients with rheumatoid arthritis (RA).
  
  
  METHODS
  BMI, disease activity, selected CVD risk factors and CVD medication were assessed in 378 (276 women) patients with RA. Patients exceeding accepted thresholds in >or=3 CVD risk factors were classified as having the metabolic syndrome (MetS).
  
  
  RESULTS
  BMI independently associated with hypertension (OR = 1.28 (95% CI = 1.22 to 1.34); p = 0.001), high-density lipoprotein (OR = 1.10 (95% CI = 1.06 to 1.15); p = 0.025), insulin resistance (OR = 1.13 (95% CI = 1.08 to 1.18); p = 0.000) and MetS (OR = 1.15 (95% CI = 1.08 to 1.21); p = 0.000). In multivariable analyses, BMI had the strongest associations with CVD risk factors (F(1-354) = 8.663, p = 0.000), and this was followed by lipid-lowering treatment (F(1-354) = 7.651, p = 0.000), age (F(1-354) = 7.541, p = 0.000), antihypertensive treatment (F(1-354) = 4.997, p = 0.000) and gender (F(1-354) = 4.707, p = 0.000). Prevalence of hypertension (p = 0.004), insulin resistance (p = 0.005) and MetS (p = 0.000) was significantly different between patients with RA who were normal, overweight and obese, and BMI differed significantly according to the number of risk factors present (p = 0.000).
  
  
  CONCLUSIONS
  Increasing BMI associates with increased CVD risk independently of many confounders. RA-specific BMI cut-off points better identify patients with RA at increased CVD risk. Weight-loss regimens should be developed and applied in order to reduce CVD in patients with RA.
authors.affiliation: School of Sport, Performing Arts & Leisure, Wolverhampton University, Walsall, UK. as@wlv.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Stavropoulos-Kalinoglou
authors.forename: G S
authors.initials: GS
authors.lastname: Metsios
authors.forename: V F
authors.initials: VF
authors.lastname: Panoulas
authors.forename: K M J
authors.initials: KM
authors.lastname: Douglas
authors.forename: A M
authors.initials: AM
authors.lastname: Nevill
authors.forename: A Z
authors.initials: AZ
authors.lastname: Jamurtas
authors.forename: M
authors.initials: M
authors.lastname: Kita
authors.forename: Y
authors.initials: Y
authors.lastname: Koutedakis
authors.forename: G D
authors.initials: GD
authors.lastname: Kitas
mesh_terms: D000368:Aged; D000886:Anthropometry / Q000379:methods; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000503:physiopathology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007333:Insulin Resistance; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D008075:Lipoproteins, HDL