Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases: a systematic review and meta-analysis.

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metabolic syndrome 2 endocrinologydiseases
obesity 30 endocrinologydiseases
type 2 diabetes mellitus 1 endocrinologydiseases
diabetes mellitus 1 endocrinologydiseases
hypertriglyceridemia 2 endocrinologydiseases

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diabetes mellitus 22374 vascular morbidity/mortality of patients with rheumatic diseases resembles that of patients with type 2 diabetes mellitus further helps define the severity of the CV risk in this clinical setting [[41]]. In fact, obesity is
hypertriglyceridemia 3400 metabolic syndrome and of some of its major features (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia , impaired fasting glucose) [[5]], increased platelet reactivity [[6]–[8]], higher degree of subclinical
hypertriglyceridemia 22856 metabolic syndrome and of some of its major features (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia , and impaired fasting glucose). However, such an association does not entirely explain the extent of
metabolic syndrome 3301 characterized by an increased cardiovascular (CV) risk [[3], [4]], as represented by a higher prevalence of metabolic syndrome and of some of its major features (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia,
metabolic syndrome 22757 proinflammatory state. Moreover, subjects with rheumatic diseases exhibit an enhanced prevalence of the metabolic syndrome and of some of its major features (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia,
obesity 458 (pmc-release): 12/2016Publication date (ppub): /2016AbstractBackgroundIn this study, we evaluated the impact of obesity and/or overweight on the achievement of minimal disease activity (MDA) in patients with psoriatic arthritis
obesity 1805 0.867, 95% CI 0.757–0.994, p = 0.041, I2 = 64%, p = 0.007). Interestingly, the effect of obesity on MDA was confirmed when we separately analyzed data on patients with RA and patients with PsA. In
obesity 2168 duration, age, male sex, and treatment duration are covariates significantly affecting the effect of obesity /overweight on MDA achievement.ConclusionsThe results of our meta-analysis suggest that obesity and overweight
obesity 2263 effect of obesity/overweight on MDA achievement.ConclusionsThe results of our meta-analysis suggest that obesity and overweight reduce the chances to achieve MDA in patients with rheumatic diseases receiving treatment
obesity 3355 [4]], as represented by a higher prevalence of metabolic syndrome and of some of its major features ( obesity , hypertension, hypercholesterolemia, hypertriglyceridemia, impaired fasting glucose) [[5]], increased
obesity 3694 arterial stiffness [[10]–[12]]. In particular, several studies have shown a higher prevalence of obesity in patient with PsA and patients with RA than in the general population. Obesity causes an abnormal
obesity 3960 [TNF-α], interleukin-6 [IL-6], adiponectin, leptin), which leads to a proinflammatory status. Thus, obesity can be considered a low-grade, chronic systemic inflammatory disease [[13], [14]]. Moreover, immune-mediated
obesity 4119 inflammatory disease [[13], [14]]. Moreover, immune-mediated inflammation may act synergistically with obesity -mediated inflammatory status and may influence disease activity in rheumatic diseases [[13], [15], [16]].
obesity 4546 and not confirmed by other studies [[18], [19]]. In the present meta-analysis, we evaluated whether obesity and overweight impact the clinical response in patients with PsA and patients with RA receiving treatment
obesity 5521 following search terms in all possible combinations: psoriatic arthritis, rheumatoid arthritis, obese, obesity , overweight, body mass index, body composition, body weight, adiposity. The latest search was performed
obesity 9486 confounders. In addition, a further sensitivity analysis was performed after excluding studies defining obesity as BMI >25 kg/m2 and the study defining MDA as an on-treatment DAS28 < 5.1.Meta-regression analysesWe
obesity 10900 the analysis. All the included studies stratified the study population according to the presence of obesity . In addition, eight studies [[17]–[19], [29]–[33]] also reported data on overweight patients.Study
obesity 11160 included studies are shown in Table 1. With the exception of three studies in which researchers defined obesity as a BMI >25 kg/m2 [[18], [27], [28]], patients were categorized into the following groups according
obesity 13985 exclusion of one study at a time. Overall, the risk of not achieving MDA attributable to the presence of obesity was 38.2%.Fig. 1Forest plot of minimal disease activity achievement in obese patients versus normal-weight
obesity 17243 subjects. In addition, these results were confirmed after we excluded studies [[18], [27], [28]] defining obesity as BMI >25 kg/m2 and the study [[32]] defining MDA as an on-treatment DAS28 < 5.1 (Additional file
obesity 17693 (Additional file 1: Figure S3). Egger’s test confirmed the absence of publication bias both for studies on obesity (p =0.285) and for studies on overweight (p = 0.314).Meta-regression analysisTo further assess the
obesity 18709 obese patients and control subjectsDiscussionIn the present meta-analysis, we evaluated the impact of obesity or overweight on the achievement of MDA in patients with PsA and patients with RA receiving treatment
obesity 20028 verify this hypothesis.With regard to age and sex, we found that the reduction in MDA achievement due to obesity is more significant in males and in younger subjects. This finding is of particular interest, considering
obesity 20351 achieve MDA during treatment with antirheumatic drugs [[30], [35]]. Thus, according to our results, obesity could hamper the effect of these predictors of MDA achievement. However, these results could be due
obesity 20647 address this issue.Several different mechanisms may be involved in the explanation of the impact of obesity on MDA achievement. It is known that adipose tissue has an endocrine function because it secretes many
obesity 21187 vasodilation. Low serum levels of adiponectin have been reported in several chronic diseases such as obesity and psoriasis. Both leptin and PAI-1 induce endothelial dysfunction. In addition, IL-6 and TNF-α promote
obesity 21790 self-maintained system.A further relevant information that could be derived from our study is the prevalence of obesity in patients with rheumatic disease. Interestingly, patients were consecutively enrolled in the included
obesity 21987 in the included studies, and among 6693 patients (1562 with PsA and 5131 with RA), the prevalence of obesity or overweight was about 50%. This finding further strengthens the hypothesis of the high prevalence
obesity 22483 mellitus further helps define the severity of the CV risk in this clinical setting [[41]]. In fact, obesity is associated with a hyperexpression of TNF-α and other adipokines (e.g., IL-6, leptin, adiponectin)
obesity 22811 diseases exhibit an enhanced prevalence of the metabolic syndrome and of some of its major features ( obesity , hypertension, hypercholesterolemia, hypertriglyceridemia, and impaired fasting glucose). However, such
obesity 23960 studies. Interestingly, all studies used standardized BMI cutoffs to define the presence/absence of obesity /overweight. However, three studies that defined obesity as a BMI >25 kg/m2 [[18], [27], [28]] did not
obesity 24016 BMI cutoffs to define the presence/absence of obesity/overweight. However, three studies that defined obesity as a BMI >25 kg/m2 [[18], [27], [28]] did not provide separate data for overweight and obesity. Interestingly,
obesity 24112 defined obesity as a BMI >25 kg/m2 [[18], [27], [28]] did not provide separate data for overweight and obesity . Interestingly, when we repeated the analyses after excluding these three studies, all results were
obesity 25066 and Coates criteria also include ESR and CRP values for the assessment of disease activity. Because obesity is associated with low-grade inflammation [[13]], ESR and CRP levels can result in elevated independently
obesity 26685 analyzed data on PsA and RA.ConclusionsDespite some limitations, the results of our study suggest that obesity and overweight reduce the chances to achieve MDA in patients with rheumatic diseases starting treatment
type 2 diabetes mellitus 22367 the vascular morbidity/mortality of patients with rheumatic diseases resembles that of patients with type 2 diabetes mellitus further helps define the severity of the CV risk in this clinical setting [[41]]. In fact, obesity is

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