Obese patients report higher disease activity, more depressive symptoms, and greater pain and fatigue.
In patients with systemic lupus erythematosus (SLE), obesity is an independent risk factor for worse disease activity, depression, pain, and fatigue.
Obesity is increasingly more common among patients with SLE, and some research has shown that it may exacerbate inflammation. Dr. Sarah Patterson and colleagues from the University of California, San Francisco point out that obesity has been linked to poor outcomes in rheumatoid arthritis but has not been studied in patients with SLE.
Patients with SLE experience lower quality of life and greater physical burden from their symptoms than the greater population; however, it is not known specifically why this is. The authors note, “Neither disease-specific factors such as disease activity nor socio-demographic factors such as poverty fully explain the observed severity of these symptoms.”
Dr. Patterson and colleagues sought to determine whether obesity in some way worsens patient-reported outcomes. They reported their findings at the recent American College of Rheumatology annual meeting in San Diego, California.
The authors utilized data from the Arthritis Body Composition and Disability Study. Body mass index was used to determine obesity, and patient-reported measures of depressive symptoms, pain, fatigue, and disease activity were collected.
• 148 patients with SLE were ultimately studied: 65% were white, 14% Asian, and 13% African American.
• 17% of subjects were in poverty, and 86% had post-high school education.
• 45% of subjects had taken steroids.
• Obese patients reported higher disease activity, more depressive symptoms, and more pain and fatigue than non-obese patients with SLE.
Implications for physicians
• Screen patients with SLE for obesity, assess them for psychosocial symptoms, and treat them accordingly.
• Expect higher perceived disease activity in obese lupus patients and work toward a solution through treatment of their lupus as well as lifestyle modification and weight reduction programs.
• Just as cardiovascular risk is an important co-factor in inflammatory disorders, obesity mitigation may improve outcomes in both SLE and cardiovascular disease.
American College of Rheumatology Press Release. “Obesity Linked with Depressive Symptoms and Increased Disease Activity in Women With Lupus.” November 4, 2017. ACR/ARHP Annual Meeting. San Diego, California.