AB0333 EFFECT OF OBESITY ON THE COURSE OF RHEUMATOID ARTHRITIS AND CARDIOVASCULAR RISK
Authors: Svetlana Lapshina, Liutsiia Feiskhanova, Luciya Kupkenova, Ridiya Sharafutdinova, Albina Yusupova
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The literature shows that the level of pro-inflammatory cytokines increases in obesity. High body mass index (BMI) is increasingly common in rheumatoid arthritis (RA), which can aggravate cardiovascular risks. <h3>Objectives</h3> The aim is to study the effect of obesity on the course of RA and cardiovascular risk. <h3>Methods</h3> 100 patients (male-7%, female-93%) aged from 21 to 81 years (average age 55 12.4) with reliable RA were examined. High activity in DAS28 scale was observed in 68%, moderate - in 30%, low - in 2%, rheumatoid factor (RF) positivity - in 88%, ACCP - 81%. DMARDs received 78%, glucocorticosteroids 60% of patients. Arterial hypertension (AH) was present in 45% of patients. BMI ranged from 15 to 46.5 kg/m<sup>2</sup> (average 26.85.7). The patients were divided into three groups: the 1st (n=38) with a normal BMI up to 25 kg/m<sup>2</sup>, the 2nd (n=24) - with heightened BMI 25-29.9 kg/m<sup>2</sup>, the 3rd group (n=28) - more than 30 kg/m<sup>2</sup>. Patients were examined in standard laboratory tests, all of them had echocardiogram. <h3>Results</h3> Patients in the groups with normal and heightened BMI had no statistical differences in manifestations of articular syndrome. In the 3rd group with obesity reliably higher (p&lt;0.05), compared with the 1st group, the intensity of pain, according to VAS (49.826.1 vs 39.116.3), the number of painful joints (20.17.8 vs 158.9), ESR (32.315.9 vs 21.014.9), DAS28 activity 4.40.5 vs 3.90.6. However, there was no significant difference depending on the level of CRP, the presence of RF, ACCP, and the x-ray stage of RA. There were no differences in the range of received therapy, but the dosage of prednisone was higher in the 3rd group with obesity (8.654.4 mg) and in the 2nd group (7.152.5 mg) compared with the 1st group (6,33,6 mg), p&lt;0.05. The level of systolic blood pressure (BP) correlated with BMI, although even in the group with obesity it was 136.421.9 (p&lt;0.01). Also, the level of BP correlated (p&lt;0.05) with the severity of pain syndrome. The verified AH was present in 6 (15.8%) people of the 1st group, in 16 (66.7%) people of the 2nd group and in 21 (75%) people of the 3rd group. The level of cholesterol, glucose, lipids did not differ significantly in the three groups. According to echocardiogram, an increase in BMI was associated with an increase in the thickness of the posterior wall of the LV and interventricular septum, an increase in LV end-diastolic size, a decrease in the tricuspid E/A ratio, an increase in the LV myocardial mass index (p&lt;0.01). The increase in LVMI correlated (p&lt;0.01) with RA activity (DAS 28), pain intensity by VAS, increase in ESR (p&lt;0.01). <h3>Conclusion</h3> RA in patients with obesity is characterized by a higher activity first of all because of pain syndrome. Increased BMI leads to bad prognostic myocardial changes in patients with RA, while cholesterol and blood pressure may stay within the normal range. This causes the need of using the echocardiography for this group of patients. <h3>References</h3> [1] rheumatoid arthritis, body mass index <h3>Disclosure of Interests</h3> None declared