Obesity and its measurement in a community-based sample of women with systemic lupus erythematosus.
OBJECTIVE
To determine the prevalence of obesity and evaluate how accurately standard anthropometric measures identify obesity among women with systemic lupus erythematosus (SLE).


METHODS
Dual x-ray absorptiometry (DXA), height, weight, and waist and hip circumference measurements were collected from 145 women with SLE. Three anthropometric proxies of obesity (body mass index [BMI]≥30 kg/m2, waist circumference [WC]≥88 cm, and waist:hip ratio [WHR]≥0.85) were compared with a DXA-based obesity criterion. Correspondence between measures was assessed with Cohen's kappa. Receiver operating characteristic curves determined optimal cut points for each anthropometric measure relative to DXA. Framingham cardiovascular risk scores were compared among women who were classified as not obese by both traditional and revised anthropometric definitions, obese by both definitions, and obese only by the revised definition.


RESULTS
Of the 145 women, 28%, 29%, 41%, and 50% were classified as obese by WC, BMI, WHR, and DXA, respectively. Correspondence between anthropometric and DXA-based measures was moderate. Women misclassified by anthropometric measures had less truncal fat and more appendicular lean and fat mass. Cut points were identified for anthropometric measures to better approximate DXA estimates of percent body fat: BMI≥26.8 kg/m2, WC≥84.75 cm, and WHR≥0.80. Framingham risk scores were significantly higher in women classified as obese by either traditional or revised criteria.


CONCLUSIONS
A large percentage of this group of women with SLE was obese. Substantial portions of women were misclassified by anthropometric measures. Utility of revised cut points compared with traditional cut points in identifying risk of cardiovascular disease or disability remains to be examined in prospective studies, but results from the Framingham risk score analysis suggest that traditional cut points exclude a significant number of at-risk women with SLE.
Katz
Patricia
P
Arthritis Research Group, University of California, San Francisco, CA 94143-0920, USA. patti.katz@ucsf.edu
Gregorich
Steven
S
Yazdany
Jinoos
J
Trupin
Laura
L
Julian
Laura
L
Yelin
Edward
E
Criswell
Lindsey A
LA
D015502:Absorptiometry, Photon; D000328:Adult; D015992:Body Mass Index; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence
Arthritis Rheum. 2008 Jan 15;59(1):136-43
18163398
Circulation. 2008 Feb 12;117(6):743-53
18212285
Am J Clin Nutr. 1998 Jan;67(1):44-9
9440374
Cancer. 1950 Jan;3(1):32-5
15405679
Eur J Nutr. 2009 Aug;48(5):315-22
19333642
Am J Clin Nutr. 1989 Jun;49(6):1283-9
2729167
Arthritis Rheum. 2003 Apr 15;49(2):263-6
12687521
Am J Clin Nutr. 2000 Sep;72(3):694-701
10966886
J Appl Physiol (1985). 1996 Mar;80(3):824-31
8964743
Int J Epidemiol. 2006 Feb;35(1):83-92
16339600
Am J Physiol. 1989 Jun;256(6 Pt 1):E829-34
2735405
J Rheumatol. 2002 Dec;29(12):2551-4
12465150
Obstet Gynecol. 2010 May;115(5):982-988
20410772
Eur Heart J. 2010 Mar;31(6):737-46
19933515
JAMA. 2009 Nov 11;302(18):1993-2000
19903920
Arthritis Rheum. 2002 Oct;46(10):2574-7
12384914
Arthritis Rheum. 2009 Oct 15;61(10):1396-402
19790130
J Appl Physiol (1985). 2003 Jun;94(6):2368-74
12598481
Biometrics. 1997 Sep;53(3):823-37
9333348
World Health Organ Tech Rep Ser. 1995;854:1-452
8594834
Arthritis Rheum. 2007 Feb 15;57(1):56-63
17266065
Lupus. 2000;9(3):170-5
10805483
Menopause. 2008 Jul-Aug;15(4 Pt 1):619-27
18202591
Rheumatology (Oxford). 1999 Jan;38(1):59-65
10334684
Genes Immun. 2007 Jun;8(4):279-87
17344889
J Rheumatol. 2004 Jan;31(1):23-9
14705214
Am J Clin Nutr. 2009 Dec;90(6):1579-85
19864405
Ann Rheum Dis. 2006 May;65(5):581-4
16150789
Int J Obes Relat Metab Disord. 2002 Jul;26(7):953-60
12080449
Am J Clin Nutr. 2000 Aug;72(2):401-6
10919934
Br J Rheumatol. 1998 May;37(5):514-9
9651078
Int J Obes (Lond). 2010 May;34(5):791-9
20125098
J Appl Physiol (1985). 1999 Oct;87(4):1513-20
10517786
Am J Clin Nutr. 1990 Jun;51(6):1106-12
2349926
Am J Med. 1992 Nov;93(5):513-9
1442853
Int J Cardiol. 2002 Sep;85(1):89-99
12163213
J Am Geriatr Soc. 2002 May;50(5):897-904
12028178
Int J Obes (Lond). 2008 Jun;32(6):959-66
18283284
Arthritis Rheum. 2009 Mar 15;61(3):370-7
19248127
Am J Clin Nutr. 2002 Oct;76(4):774-9
12324290
World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
11234459
Br J Rheumatol. 1997 Apr;36(4):444-8
9159537
Lupus. 2003;12(4):280-6
12729051