title: Effects of obesity on health-related quality of life in juvenile-onset systemic lupus erythematosus.
abstract: OBJECTIVE
  This study evaluated the effects of obesity on health-related quality of life (HRQOL) measures in juvenile-onset systemic lupus erythematosus (jSLE).
  
  
  METHODS
  Obesity was defined as a body mass index (BMI) ≥ 95 th percentile according to the Sex-specific Center for Disease Control BMI-For-Age Charts and determined in a multicenter cohort of jSLE patients. In this secondary analysis, the domain and summary scores of the Pediatric Quality of Life (PedsQL) Inventory and the Child Health Questionnaire (CHQ) of obese jSLE patients were compared to those of non-obese jSLE patients as well as historical obese and non-obese healthy controls. Mixed-effects modeling was performed to evaluate the relationship between obesity and HRQOL measures.
  
  
  RESULTS
  Among the 202 jSLE patients, 25% (n = 51) were obese. Obesity had a significant negative impact on HRQOL in jSLE, even after adjusting for differences in current corticosteroid use, disease activity, disease damage, gender and race between groups. Obese jSLE patients had lower physical functioning compared to non-obese jSLE patients, and to non-obese and obese healthy controls. Compared to their non-obese counterparts, obese jSLE patients also had worse school functioning, more pain, worse social functioning and emotional functioning. Parents of obese jSLE patients worry more. The CHQ scores for obese jSLE patients were also worse compared to non-obese jSLE patients in several other domains.
  
  
  CONCLUSIONS
  Our study demonstrates the detrimental effects of obesity on patient-reported outcomes in jSLE. This supports the importance of weight management for the therapeutic plan of jSLE.
authors.affiliation: Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA University of Cincinnati, Cincinnati, OH, USA minara@ucmail.uc.edu.
authors.forename: R
authors.initials: R
authors.lastname: Mina
authors.affiliation: Division of Pediatric Rheumatology, Children's Memorial Hospital, Chicago, IL, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Klein-Gitelman
authors.affiliation: Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: S
authors.initials: S
authors.lastname: Nelson
authors.affiliation: Division of Pediatric Rheumatology, Steven and Alexandra Cohen Children's Medical Center of NY, New York, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Eberhard
authors.affiliation: Division of Pediatric Rheumatology, Nationwide Children's Hospital and Ohio State University, Columbus, OH, USA.
authors.forename: G
authors.initials: G
authors.lastname: Higgins
authors.affiliation: Division of Rheumatology, MetroHealth Medical Center & Case Western Reserve University, Cleveland, OH, USA.
authors.forename: N G
authors.initials: NG
authors.lastname: Singer
authors.affiliation: Division of Pediatric Rheumatology, University of Chicago Comer Children's Hospital, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Onel
authors.affiliation: Division of Pediatric Rheumatology, BC Children's Hospital, Vancouver, BC, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Tucker
authors.affiliation: Section of Rheumatology, Riley Hospital for Children, Indianapolis, IN, USA.
authors.forename: K M
authors.initials: KM
authors.lastname: O'Neil
authors.affiliation: Division of Pediatric Rheumatology, Texas Scottish Rite Hospital, Dallas, TX, USA.
authors.forename: M
authors.initials: M
authors.lastname: Punaro
authors.affiliation: Division of Rheumatology, Hospital for Sick Children and University of Toronto, Toronto, Canada.
authors.forename: D M
authors.initials: DM
authors.lastname: Levy
authors.affiliation: Section of Pediatric Rheumatology & Immunology, Joseph M. Sanzari Children's Hospital, Hackensack UMC, Hackensack, NJ, USA.
authors.forename: K
authors.initials: K
authors.lastname: Haines
authors.affiliation: University of Cincinnati, Cincinnati, OH, USA.
authors.forename: J
authors.initials: J
authors.lastname: Ying
authors.affiliation: Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: H I
authors.initials: HI
authors.lastname: Brunner
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D008297:Male; D009765:Obesity / Q000150:complications*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Systemic lupus erythematosus; children; health-related quality of life; obesity; pediatrics