Objective To explore the relationship between body mass index(BMI),percentage of body fat(PBF)and rheumatoid arthritis(RA).Methods Three hundred and fifty-nine patients with RA and 155 age,gender-matched normal controls were recruited. All the individuals were divided into weight loss,normal,overweight and obesity group according to BMI and classified into normal and obesity according to PBF,respectively. Disease activity score(DAS28)was detected in RA patients. X-ray examinations of both hands were graded according to Sharp method.Differences of BMI and PBF between RA and normal groups were compared and associations of BMI and PBF with RA were analyzed.Results BMI in RA patients was lower than that in controls[(22.40 ± 3.76)kg/m2vs(23.66 ± 3.24)kg/m2, P<0.001].Percentage of weight loss in RA patients was obviously higher than that in controls(14.2%vs 5.8%,P=0.006).However,PBF in RA was clearly higher than that in controls[(32.45 ± 10.38)%vs(30.53 ± 6.98)%,P=0.015].ESR(P=0.036)and Sharp scores(P=0.044)were diverse among four groups with different BMI,which represented as higher level in weight loss group and lower level in obesity group.HAQ score in weight loss group was higher than that in other 3 groups(P<0.05).Indicator s of disease activity were not statistically different between different PBF groups(P>0.05).PBF were not statistically different among different DAS28 groups(P > 0. 05). Linear regression didn't reveal associations between DAS28 and BMI,PBF(P>0.05).Negatively correlation between Sharp score and BMI,and positively correlation between Sharp score and PBF were found(P<0.05).Conclusion BMI and PBF change differently in RA,which are not in correlation with disease activity but are associated with bone erosion.%目的 探讨体重指数(BMI)和体脂百分比(PBF)与类风湿关节炎(RA)病情的相关性.方法 选取359例RA患者(RA组)和155例健康体检者(对照组),依据BMI将两组受试者分别分为消瘦组、正常组、超重组和肥胖组,依据PBF分为正常组和肥胖组,检查RA患者的疾病活动性评分(DAS28)等疾病活动性指标,拍摄双手X线正位片并进行Sharp评分,比较两组间BMI和PBF并分析其与 RA病情评估相关指标间的关系.结果 RA患者 BMI低于对照组[(22.40 ±3.76)kg/m2比(23.66 ± 3.24)kg/m2,P<0.001],其中消瘦组患者比例高于对照组(14.2%比5.8%,P=0.006);RA组的PBF高于对照组[(32.45 ± 10.38)%比(30.53 ± 6.98)%,P=0.015).不同BMI组ESR和Sharp评分比较差异有统计学意义(P=0.036,P=0.044),均表现为消瘦组水平更高、肥胖组水平更低,消瘦组健康评价表(HAQ)积分也明显高于其他3组(P=0.036);不同PBF分组间病情评估相关指标比较差异均无统计学意义(P>0.05).不同DAS28评分组间BMI及PBF比较,差异无统计学意义(P>0.05).多元线性回归分析结果显示,DAS28与BMI和PBF均无相关性(P>0.05);Sharp评分与BMI呈负相关,而与PBF呈正相关(P<0.05).结论 BMI和PBF在RA中变化不同,其均与RA病情活动性无关,而与RA患者局部骨侵蚀具有确切的相关性.
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