UNASSIGNED: Each of the 1318 patients from a real-world Chinese RA population was first stratified by gender and then individually age-matched with one American RA patient from the US National Health and Nutritional Examination Survey 1999-2018. Data on BMI, bilateral hand radiographs and risk factors at enrolment were collected but radiographs were unavailable for the American patients. Logistic regression was used to evaluate the association of BMI with radiographic joint damage (RJD) in Chinese patients.
UNASSIGNED: Chinese patients had a significantly lower BMI [(weighted) median 21.8 vs 29.8 kg/m2; P < 0.001] and a higher prevalence of being underweight (15.2% vs 1.1%; P < 0.05) than their American counterparts. Underweight Chinese patients (BMI <18.5) had higher modified total Sharp scores (median 17 vs 10) and joint space narrowing (JSN) subscores (median 6 vs 2) (both P < 0.05) than normal-weight patients (BMI ≥18.5-<24). After controlling for confounding, continuous BMI was cross-sectionally negatively associated with RJD [adjusted prevalence odds ratio (OR) 0.90 (95% CI 0.85, 0.96)] and JSN [adjusted prevalence OR 0.92 (95% CI 0.87, 0.96)]; being underweight vs normal weight was associated with RJD [adjusted prevalence OR 2.14 (95% CI 1.37, 3.35)] and JSN [adjusted prevalence OR 1.77 (95% CI 1.10, 2.84)].
UNASSIGNED: Low BMI and being underweight were cross-sectionally associated with joint damage in Chinese RA patients, especially JSN, suggesting the clinical importance of identifying underweight patients and focusing on weight gain to prevent joint damage.
首先对来自真实世界中国RA人群的1318名患者进行性别分层,然后分别与1999-2018年美国国家健康和营养检查调查的一名美国RA患者进行年龄匹配。BMI数据,我们收集了纳入时的双侧手部X线照片和危险因素,但没有美国患者的X线照片.采用Logistic回归分析评估中国患者BMI与影像学关节损伤(RJD)的相关性。
■中国患者的BMI[(加权)中位数为21.8vs29.8kg/m2;P<0.001]和体重不足的患病率(15.2%vs1.1%;P<0.05)明显低于美国患者。中国体重过轻患者(BMI<18.5)的改良总Sharp评分(中位数17vs10)和关节间隙狭窄(JSN)子评分(中位数6vs2)(均P<0.05)高于正常体重患者(BMI≥18.5-<24)。在控制了混淆之后,连续BMI与RJD[校正患病率比值比(OR)0.90(95%CI0.85,0.96)]和JSN[校正患病率OR0.92(95%CI0.87,0.96)]呈横断面负相关;体重过轻与正常体重与RJD[校正患病率OR2.14(95%CI1.37,3.35)]和JSN[校正患病率OR1.77(95%CI1.10,2.84)相关.
■低BMI和体重过轻与中国RA患者的关节损伤相关,尤其是JSN,提示识别体重不足患者并关注体重增加以防止关节损伤的临床重要性。