Obesity is associated with pain and impaired mobility despite therapy in systemic lupus erythematosus

Frontiers in Medicine

Medicine

Emelie Heintz¹  Malin Regardt²  David Grannas³  Alexander Borg⁴  Yvonne Enman⁴  Sharzad Emamikia⁴  Julius Lindblom⁴  Alvaro Gomez⁴  Ameneh Soltani⁴  Ioannis Parodis⁵ 

[1] Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden;Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden;Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden;Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden;Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden;Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;

关键词: systemic lupus erythematosus;    body mass index;    health-related quality of life;    patient reported outcomes;    patient perspective;   

DOI  :  10.3389/fmed.2023.1247354

 received in 2023-06-26, accepted in 2023-08-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo investigate whether abnormal BMI is associated with health-related quality of life (HRQoL) impairments, defined as patient-reported problems within the different dimensions of the three-level EQ-5D (EQ-5D-3L), before and after treatment for active systemic lupus erythematosus (SLE).Patients and methodsWe conducted a post-hoc analysis of data from two phase III clinical trials of belimumab in SLE, i.e., BLISS-52 (n = 865) and BLISS-76 (n = 819). Underweight was defined as BMI <18.5 kg/m2, normal weight as BMI ≥18.5 but <25 kg/m2, pre-obesity as BMI ≥25 but <30 kg/m2, and obesity as BMI ≥30 kg/m2. We investigated associations between BMI groups and problems (level 2 or 3) within each one of the five EQ-5D dimensions before treatment initiation and at week 52, using logistic regression analysis adjusting for age, ethnicity, disease activity, and glucocorticoid dose, and for the post-treatment analysis also for belimumab treatment and baseline EQ-5D-3L responses.ResultsOf 1,684 patients included, 73 (4%) were classified as underweight, 850 (50%) as normal weight, 438 (26%) as pre-obese, and 323 (19%) as obese. At baseline, obesity was associated with mild to severe problems in all EQ-5D dimensions (p < 0.05 for all), yielding the strongest association with problems in mobility (adjusted odds ratio, aOR: 2.1; 95% confidence interval, CI: 1.6–2.8; p < 0.001). Pre-obesity was also associated with problems in mobility (aOR: 1.4; 95% CI: 1.1–1.8; p = 0.005). Post-intervention, obesity was associated with problems in mobility and pain/discomfort, and pre-obesity with problems in mobility and self-care (p < 0.05 for all).ConclusionOur study adds to the evidence that high BMI negatively affects SLE patients’ HRQoL, with obesity being associated with pain and impaired mobility despite therapy.

【 授权许可】

Unknown   
Copyright © 2023 Borg, Lindblom, Gomez, Soltani, Enman, Heintz, Regardt, Grannas, Emamikia and Parodis.