POS0993 THE IMPORTANCE OF PHYSICAL ACTIVITY IN RELATION TO BEING OVERWEIGHT/OBESE WITH AXIAL SPONDYLOARTHRITIS. RESULTS FROM THE SPANISH ATLAS
Authors: M. Garrido-Cumbrera, E. Collantes-Estevez, V. Navarro-Compán, P. Zarco-Montejo, J. Correa-Fernández, C. Sastré, P. Plazuelo-Ramos, J. Gratacos-Masmitja
Journal: Annals of the Rheumatic Diseases (2021)

Background: Evidence on the negative effects of being overweight/obese on the health outcomes of patients with axial spondyloarthritis (axSpA) is increasing. Objectives: This study aimed to identify associations between Body Mass Index (BMI) categories and disease activity, functioning, quality of life, and mental health in a large sample of axSpA patients. Methods: In 2016, a sample of 680 unselected patients with axSpA participated in the Atlas of Axial Spondyloarthritis in Spain through an online survey. The sample was divided in two groups: 1) Patients with a BMI of 18.5 to &lt;25 Kg/m2 (normal weight), and 2) Patients with a BMI of ≥ 25 Kg/m2 (overweight/obesity), excluding the underweight category (BMI &lt;18.5 Kg/m2). The Mann-Whitney and Pearson’s chi-square tests were used to analyse possible relationships between independent sociodemographic characteristics, employment, lifestyle, patient-reported outcomes, and comorbidity variables with those who are overweight/obese. Univariate and multivariate binary logistic regression was used to determine the association of the possible factors with those who are overweight/obese. Results: Of the 663 patients analysed, the mean age was 45.9 years, 51.4% were female, 37.0% had a university degree, and 72.5% were married. The prevalence of overweight/obese patients was 53.4% compared to 46.6% who were of a normal weight. The patients with the highest prevalence of being overweight/obese were older (49.3 vs 42.0, p&lt;0.001), with no university education (59.8% vs 42.4% of university, p&lt;0.001), often widowers (75.0% vs 30.8% of single people, p&lt;0.001), and reported membership of patient organisations (61.7% vs 46.6%, p&lt;0.001). With respect to patients of normal weight, those who were overweight/obese presented greater spinal stiffness (8.2 vs 6.6, p&lt;0.001) and a longer diagnostic delay (9.2 vs 7.8, p=0.005). In addition, patients who were overweight/obese were more likely physically inactive (63.7% vs 36.3%, p=0.007). In the multivariable binary logistic regression analysis, the qualitative factors associated with the presence of being overweight/obese were physical inactivity (OR= 2.40) and males (OR= 1.81), while the quantitative factor most associated with the presence of being overweight/obese were greater spinal stiffness (B= 0.121) and older in age (B= 0.052) (Table 1). Table 1. Logistic regression to analyses factor associated with being overweight/obese (N= 469) Univariate logistic analysis Multivariate logistic analysis OR p-value 1 OR p-value 1 Qualitative factors Gender. Male 2.376 &lt;0.001 1.811 0.005 Educational level. No university 2.018 &lt;0.001 1.188 0.422 Marital Status. Widowed 2.647 0.235 NA NA Member of PAGs. Yes 1.851 &lt;0.001 1.095 0.680 Employment. Retired / early retirement 4.414 &lt;0.001 1.732 0.195 Physical activity. No 1.703 0.007 2.400 0.038 Quantitative factors B p-value 2 B p-value 2 Age 0.070 &lt;0.001 0.052 &lt;0.001 Spinal Stiffness (3-12) 0.220 &lt;0.001 0.121 0.004 Diagnostic Delay 0.024 0.035 0.008 0.568 1 p-value for test H 0 : OR = 1 2 p-value for test H 0 : B = 0. Conclusion: Being overweight/obese is a common comorbidity among patients with axSpA. The lack of physical activity, male gender, higher spinal stiffness, and older age increase the probability of prevalence of being overweight/obese. Physicians should encourage physical activity in patients with axSpA, especially among men and older people to prevent the factors of being overweight/obese. Acknowledgements: This study was supported by Novartis Spain. The authors would like to thank all patients who participated in the study. Disclosure of Interests: Marco Garrido-Cumbrera: None declared, Eduardo Collantes-Estevez Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Victoria Navarro-Compán Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB, Pedro Zarco-Montejo: None declared, José Correa-Fernández: None declared, Carlos Sastré Employee of: Novartis Farmacéutica Spain, Pedro Plazuelo-Ramos: None declared, Jordi Gratacos-Masmitja Grant/research support from: Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, and UCB.