Central obesity in women with axSpA leads to worse outcomes

Central obesity, as assessed by the waist-to-hip ratio (WHR), is very common in patients with axial spondyloarthritis (axSpA), particularly in women, reveals a recent study. This modifiable comorbidity may result in worse quality of life, worse disease activity, and greater impairment of functional ability.

Study investigators extracted data from the Ankylosing Spondylitis Registry of Ireland and included patients with physical measurement for the calculation of anthropometric measures. They used body mass index (BMI) and WHR to compare classifications of obesity, as well as performed comparison analyses based on sex and central obesity.

Multivariate analysis was conducted to analyse the effects of these factors on the following patient-reported outcomes: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire, and the Health Assessment Questionnaire (HAQ).

A total of 753 patients met the eligibility criteria, of which 233 (29.6 percent) were classified as obese based on their BMI and 311 (41.3 percent) as centrally obese according to the WHR. Central obesity was significantly more prevalent among women with axSpA than men (71.6 percent vs 29.9 percent; p<0.01).

Regardless of sex, central obesity showed a clear impact on patient outcomes. Its presence was associated with significantly worse BASFI scores (p<0.01), HAQ scores (p<0.01), and ASQoL questionnaire scores (p=0.01), with a nonsignificant trend toward worse BASDAI scores (p=0.07).

“Regular use of the WHR to screen for central obesity as part of an axSpA assessment would provide an opportunity for prompt identification and intervention for at-risk patients,” the investigators said.