Impact of Body Mass Index on Disease Severity in Rheumatoid Arthritis Patients

Abstract

Introduction: Rheumatoid Arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation and systemic manifestations, significantly impacting patients’ quality of life. Objective: This study investigates the association of Body Mass Index (BMI) with disease severity in RA patients, focusing on inflammatory markers and clinical parameters. Materials and Method: A cross-sectional design was employed, enrolling RA patients from a rheumatology clinic who met specific inclusion criteria. Participants (n=90) were categorized into four BMI groups: normal, overweight, pre-obese, and obese. Clinical assessments included tender joint count (TJ28), swollen joint count (SJ28), and Disease Activity Score (DAS28-ESR), alongside biochemical markers such as Erythrocyte Sedimentation Rate (ESR), Rheumatoid Factor (RF), and Anti-Cyclic Citrullinated Peptide (ACCP). Results: Statistical analysis revealed that higher BMI correlates with increased disease activity; notably, the obese group exhibited significantly elevated levels of ESR(p=0.026*), TJ28(p=0.014*), SJ28(p=0.030*), and DAS28-ESR(p=0.024*) compared to other groups. The pre-obese group also showed higher ESR levels than those with normal BMI. These findings suggest that obesity exacerbates inflammation in RA patients, potentially due to adipose tissue secreting pro-inflammatory cytokines. Despite no significant difference in RF and ACCP in the BMI categories, the results highlight the direct effect of an increase in BMI on the disease severity in RA. Clinical outcomes in RA can be improved by weight management. Further research is required to elucidate the mechanistic role of obesity in enhancing the disease severity in RA. Conclusion: High BMI is significantly associated with an increase in the severity of rheumatoid arthritis. RA patients with obesity show an increase in inflammation and disease activity.