AB0531 OBESITY INCREASES THE INCIDENCE OF NEW-ONSET LUPUS NEPHRITIS AND ORGAN DAMAGE DURING FOLLOW-UP IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. (June 2019)

• Record Type: Journal Article
• Authors: Lee, Shin-Seok; Kang, Ji-Hyoun; Choi, Sung-Eun; Xu, Haimuzi; Park, Dong-Jin
• Is Part Of: Annals of the rheumatic diseases. Volume 78(2019)Supplement 2
• Page Start: 1727
• Page End: 1727
• Publication Date: 2019-06
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2019-eular.3430
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Objectives: This study investigated the detrimental effects of obesity on clinical manifestations, disease activity, and organ damage in Korean patients with systemic lupus erythematosus (SLE). Methods: We obtained data on 393 SLE patients from the Korean Lupus Network registry. Demographic variables, clinical manifestations, laboratory findings, Physician Global Assessment (PGA), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 and Systemic Lupus International Collaborating Clinics Group (SLICC) damage index scores were recorded at the time of enrollment. The tests were repeated annually for 3 consecutive years. We divided the patients into groups according to their body mass index (BMI) using the Asia-Pacific classification (normal, BMI < 23; overweight, 23 ≤ BMI <25; obese, BMI ≥ 25). Univariate and multivariate analyses were performed to assess the impact of obesity on clinical outcomes. Results: Of the 393 patients, 59 (15.0%) were obese at the time of enrollment. Obese patients had more comorbidities, such as diabetes ( P =0.002), hypertension ( P =0.005), hyperlipidemia ( P =0.005), and pulmonary hypertension ( P =0.036) than non-obese patients. Nephritis at enrollment and newly developed nephritis during follow-up were more common in obese patients than in non-obese patients ( P =0.002 and P =0.002, respectively). In addition, obese patients had higher daily and cumulative prednisolone doses ( P =0.010 and P =0.010, respectively) and higher rates of intravenous cyclophosphamide ( P =0.008), mycophenolate ( P =0.030), tacrolimus ( P =0.007), and cyclosporine ( P =0.019) use than non-obese patients. Furthermore, the PGA and SLICC damage index scores were higher in obese patients than in non-obese patients ( P =0.017 and P =0.039, respectively) for all 3 consecutive years. In the multivariate analysis, obesity was significantly associated with male gender (OR = 0.141, 95% CI: 0.047–0.419, P <0.001), newly developed nephritis (OR = 2.741, 95% CI: 1.080–6.957, P =0.034), and annual increase in SDI (OR = 2.185, 95% CI: 1.229–3.885, P =0.008). Conclusion: Obese SLE patients had a higher incidence of newly developed nephritis and cumulative organ damage than non-obese patients. Therefore, lifestyle modifications, including those aimed at weight loss, should be recommended for these patients to improve their clinical outcomes. Disclosure of Interests: None declared