Obesity Independently Associates with Worse Patient-Reported Outcomes in Women with Systemic Lupus Erythematosus.

BACKGROUND: We aimed to determine whether obesity in women with systemic lupus erythematosus (SLE) independently associates with worse patient-reported outcomes (PROs).

METHODS: Data derive from a prospective study of adult women who carried a diagnosis of SLE verified by medical record review. Two established definitions for obesity were used: fat mass index (FMI) ≥ 13 kg/m2 and BMI ≥ 30 kg/m2 . Dependent variables included 4 validated PROs: disease activity via Systemic Lupus Activity Questionnaire (SLAQ), depressive symptoms via Center for Epidemiologic Studies Depression Scale (CES-D), pain via Short Form 36 Health Survey (SF-36) Pain Subscale, and fatigue via SF-36 Vitality Subscale. We used multivariable linear regression to evaluate the associations of obesity with PROs while controlling for potential confounders (age, race, education, income, smoking, disease duration, disease damage, and prednisone use).

RESULTS: The analysis included 148 participants; 32% were obese. In the multivariate regression model, obesity associated with worse scores on each PRO. Mean adjusted scores for SLAQ and CES-D comparing obese versus non-obese participants were 14.8 versus 11.1 (p=0.01) and 19.8 versus 13.1 (p<0.01), respectively. The obese group also reported worse mean adjusted scores for pain (38.7 vs. 44.2, p<0.01) and fatigue (39.6 vs. 45.2, p=0.01).

CONCLUSION: In a representative sample of women with SLE, obesity (by FMI and BMI) independently associated with worse patient reported outcomes, including disease activity, depressive symptoms, and symptoms of pain and fatigue. Obesity may represent a modifiable target for improving outcomes in this patient population. This article is protected by copyright. All rights reserved.