The Relationship between Obesity and Rheumatoid Arthritis
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Abstract
Objectives: In recent years, both the prevalence of obesity and the incidence of RA have been rising. Our aim was to assess the association between overweight or obesity and rheumatoid arthritis (RA). Obesity is arguably the most worrying current public health crisis because it is both extremely common and leads to numerous adverse health outcomes. It is not, therefore, surprising that obesity has important implications for rheumatoid arthritis (RA) and its management. Obesity is an inflammatory state, with excess visceral adiposity being associated with elevation in systemic cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) . This observation has led to the hypothesis that obesity may drive and contribute to the development and perpetuation of systemic inflammatory conditions including inflammatory arthritis. In support of this concept, there appears to be a strong relationship between metabolic obesity, psoriasis, and psoriatic arthritis, with a significant reduction in the risk of psoriasis among those losing weight after bariatric surgery. A similar study, however, found no reduction in the risk of RA in patients undergoing bariatric surgery. The measurement of inflammatory biomarkers such as ESR and CRP is another objective way to assess disease activity, but these biomarkers may also be subject to bias. We showed that patients with RA who were obese were more likely to have elevated inflammatory markers, similar to what is seen in the general population. The influence of obesity on inflammatory markers has important implications for the interpretability of these measures as a disease activity measure, particularly among obese women
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