Impacto de la obesidad en la actividad de la enfermedad en pacientes con espondiloartritis axial según el sexo
Palabras clave:
obesidad, espondiloartritis axial, sexo
Resumen
Introducción: la obesidad desencadena inflamación y empeora las enfermedades reumáticas. Pocos estudios han abordado esta temática en la espondiloartritis axial (EspAax). Objetivos: evaluar la composición corporal y su influencia en los parámetros inflamatorios de la EspAax según el sexo. Materiales y métodos: se evaluó la masa corporal magra y la masa grasa mediante bioimpedancia en 60 pacientes con EspAax (30 hombres y 30 mujeres). Se utilizó BASDAI y ASDAS para evaluar la actividad de la enfermedad, y BASFI para evaluar la funcionalidad. Resultados: de los 60 pacientes incluidos, 59 (98,3%) tenían masa grasa por encima de lo normal y masa magra por debajo de lo normal. Las mujeres presentaron menor masa magra que los hombres, mayor actividad de la enfermedad y peores puntuaciones funcionales. En los hombres, tanto la masa grasa como la magra, se correlacionaron con ASDAS (r 0,41; r -0,39, respectivamente) y BASFI (r 0,53 y r -0,60, respectivamente), mientras que no hubo correlaciones en las mujeres. Conclusiones: las mujeres presentaron peor actividad de la enfermedad e índices funcionales que los varones. El aumento de la grasa corporal se correlacionó con la actividad de la enfermedad y los índices funcionales en los pacientes masculinos.Citas
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XXIV. Muhsin HY, Al-Humairi RMA, Alshareef DQJ, Ad’hiah AH. Interleukin-22 is up regulated in serum of male patients with ankylosing spondylitis. Egyptian Rheumatol.2022;44 (4):351-355. https://doi.org/10.1016/j.ejr.2022.07.002.
XXV. Shahlaee A, Mahmoudi M, Nicknam MH, Farhadi E, Fallahi S, Jamshidi AR. Gender differences in Iranian patients with ankylosing spondylitis. Clin Rheumatol. 2015; 34(2):285–93. doi: 10.1007/s10067-013-2439-4.
XXVI. van der Horst-Bruinsma IE, Zack DJ, Szumski A, Koenig AS. Female patients with ankylosing spondylitis: analysis of the impact of gender across treatment studies. Ann Rheum Dis. 2013; 72(7): 1221–4. doi: 10.1136/annrheumdis-2012-202431.
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XXVIII. Ibáñez Vodnizza S, Visman IM, van Denderen C, Lems WF, Jaime F, Nurmohamed MT, et al. Muscle wasting in male TNF-α blocker naïve ankylosing spondylitis patients: a comparison of gender differences in body composition. Rheumatology (Oxford). 2017; 56(9):1566-1572. doi: 10.1093/rheumatology/kex187.
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XXXI. Gracey E, Yao Y, Green B, Qaiyum Z, Baglaenko Y, Lin A, et al. Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis. Arthritis Rheumatol. 2016; 68(3):679-89. doi: 10.1002/art.39464.
XXXII. Huang WN, Tso TK, Kuo YC, Tsay GJ. Distinct impacts of syndesmophyte formation on male and female patients with ankylosing spondylitis. Int J Rheum Dis. 2012; 15(2):163–8.
XXXIII. Mahendira D, Thavaneswaran A, Carty A, Haroon N, Anton A, Passalent L, et al. Analysis of the effect of the oral contraceptive pill on clinical outcomes in women with ankylosing spondylitis. J Rheumatol. 2014; 41(7):1344–8. doi: 10.3899/jrheum.130996.
XXXIV. Jimenez-Balderas FJ, Tapia-Serrano R, Madero-Cervera JI, Murrieta S, Mintz G. Ovarian function studies in active ankylosing spondylitis in women. Clinical response to estrogen therapy. J Rheumatol. 1990; 17(4):497–502. PMID: 2348430.
II. Chen CH, Chen HA, Liu CH, Liao HT, Chou CT, Chen CH. Association of obesity with inflammation, disease severity and cardiovascular risk factors among patients with ankylosing spondylitis. Int J Rheum Dis. 2020; 23(9):1165-1174. doi: 10.1111/1756-185X.13912.
III. Bodur H, Ataman S, Rezvani A, Buğdaycı DS, Cevik R, Birtane M, et al. Quality of life and related variables in patients with ankylosing spondylitis. Qual Life Res. 2011; 20(4):543-9. doi: 10.1007/s11136-010-9771-9.
IV. Schäfer C, Keyßer G. Lifestyle factors and their influence on rheumatoid arthritis: A narrative review. J Clin Med. 2022; 11(23):7179. doi: 10.3390/jcm11237179.
V. Hernández-Negrín H, Ricci M, Mancebo-Sevilla JJ, Sanz-Cánovas J, López-Sampalo A, Cobos-Palacios L, et al. Obesity, diabetes, and cardiovascular risk burden in systemic lupus erythematosus: Current approaches and knowledge gaps-a rapid scoping review. Int J Environ Res Public Health. 2022; 19(22):14768. doi: 10.3390/ijerph192214768.
VI. Toussirot E, Gallais-Sérézal I, Aubin F. The cardiometabolic conditions of psoriatic disease. Front Immunol. 2022; 13:970371. doi: 10.3389/fimmu.2022.970371.
VII. Versini M, Jeandel PY, Rosenthal E, Shoenfeld Y. Obesity in autoimmune diseases: not a passive bystander. Autoimmun Rev. 2014; 13(9):981-1000. doi: 10.1016/j.autrev.2014.07.001.
VIII. Eldin AB, ElBakry SA, Morad CS, Abd-El Samie AM. The impact of metabolic syndrome on rheumatoid arthritis in a cohort of Egyptian patients. Egypt. Rheumatol. 2017;40 (1): 7-10. doi: 10.1016/j.ejr.2017.09.005.
IX. Kamela SR, Sadeka HA, Mohameda FA, Alib LH, Osman HM. Differences in body mass index, waist circumference, and waist-to-hip ratio in patients with rheumatoid arthritis: association with serum adiponectin and disease parameters. Egypt Rheumatol Rehabil. 2017; 44: 24–29. https://doi.org/10.4103/1110-161X.200837.
X. Chen YM, Chen HH, Hsieh CW, Hsieh TY, Lan JL, Chen DY. A close association of body cell mass loss with disease activity and disability in Chinese patients with rheumatoid arthritis. Clinics (Sao Paulo). 2011; 66(7):1217-22. doi: 10.1590/s1807-59322011000700016.
XI. Almousa S, Alshamaa N, Wannous H, Khder K, Qasem H. Gender related differences in axial spondyloarthritis (ax SpA) patients. Egypt Rheumatol. 2023; 45:13-16.
XII. Rusman T, van Vollenhoven RF, van der Horst-Bruinsma IE. Gender differences in axial spondyloarthritis: Women are not so lucky. Curr Rheumatol Rep. 2018; 20(6):35. doi: 10.1007/s11926-018-0744-2.
XIII. Rudwaleit M, van der Heijde D, Landewé R, Listing J, Akkoc N, Brandt J, et al. The development of assessment of SpondyloArthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009; 68(6): 777-83. doi: 10.1136/ard.2009.108233.
XIV. The Criteria Committee of the New York Heart Association. Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels, 9th ed, Little, Brown & Co, Boston 1994. p.253
XV. Machado PM, Landewé R, van der Heijde DV. Assessment of SpondyloArthritis international Society (ASAS). Ankylosing Spondylitis Disease Activity Score (ASDAS): 2018 update of the nomenclature for disease activity states. Ann Rheum Dis. 2018 . 77(10):1539-40. doi: 10.1136/annrheumdis-2018-213184.
XVI. Calin A, Garrett S, Whitelock H, Kennedy LG, O´Hea J, Malorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Functional Index. J Rheumatol. 1994; 21:2281-5. PMID: 7699629.
XVII. Choi MK, Park YM, Shivappa N, Hong OK, Han K, Steck SE, et al. Inflammatory potential of diet and risk of mortality in normal-weight adults with central obesity. Clin Nutr. 2022; 42(2):208-15. doi: 10.1016/j.clnu.2022.11.019.
XVIII. Tournadre A, Pereira B, Lhoste A, Dubost JJ, Ristori JM, Claudepierre P, et al. Differences between women and men with recent- onset axial spondyloarthritis: results from a prospective multicenter French cohort. Arthritis Care Res (Hoboken). 2013; 65(9):1482–9. doi: 10.1002/acr.22001.
XIX. Garrido-Cumbrera M, Poddubnyy D, Gossec L, Mahapatra R, Bundy C, Makri S, et al. Gender differences in patient journey to diagnosis and disease outcomes: results from the European map of axial spondyloarthritis (EMAS). Clin Rheumatol. 2021; 40(7):2753–61. doi: 10.1007/s10067-020-05558-7.
XX. Ibn Yacoub Y, Amine B, Laatiris A, Hajjaj-Hassouni N. Gender and disease features in Moroccan patients with ankylosing spondylitis. Clin Rheumatol. 2012; 31(2):293–7. doi: 10.1007/s10067-011-1819-x.
XXI. Landi M, Maldonado-Ficco H, Perez-Alamino R, Maldonado- Cocco JA, Citera G, Arturi P, et al. Gender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an Iberoamerican spondyloarthritis cohort. Medicine (Baltimore). 2016; 95(51):e5652. doi: 10.1097/MD.0000000000006485.
XXII. de Carvalho HMS, Bortoluzzo AB, Gonçalves CR, da Silva JAB, Ximenes AC, Bértolo MB, et al. Gender characterization in a large series of Brazilian patients with spondyloarthritis. Clin Rheumatol. 2012; 31(4):687–95. doi: 10.1007/s10067-011-1890-3.
XXIII. Cunha RN, Vieira-Sousa E, Khmelinskii N, Ávila-Ribeiro P, Couto M, Seixas MI, et al. Sex differences in axial spondyloarthritis: data from a Portuguese spondyloarthritis cohort. ARP Rheumatol. 2022; 1(1):42-48. PMID: 35633576.
XXIV. Muhsin HY, Al-Humairi RMA, Alshareef DQJ, Ad’hiah AH. Interleukin-22 is up regulated in serum of male patients with ankylosing spondylitis. Egyptian Rheumatol.2022;44 (4):351-355. https://doi.org/10.1016/j.ejr.2022.07.002.
XXV. Shahlaee A, Mahmoudi M, Nicknam MH, Farhadi E, Fallahi S, Jamshidi AR. Gender differences in Iranian patients with ankylosing spondylitis. Clin Rheumatol. 2015; 34(2):285–93. doi: 10.1007/s10067-013-2439-4.
XXVI. van der Horst-Bruinsma IE, Zack DJ, Szumski A, Koenig AS. Female patients with ankylosing spondylitis: analysis of the impact of gender across treatment studies. Ann Rheum Dis. 2013; 72(7): 1221–4. doi: 10.1136/annrheumdis-2012-202431.
XXVII. Webers C, Essers I, Ramiro S, Stolwijk C, Landewe R, van der Heijde D, et al. Gender-attributable differences in outcome of ankylosing spondylitis: long-term results from the Outcome in Ankylosing Spondylitis International Study. Rheumatology (Oxford). 2016; 55(3):419–28. doi: 10.1093/rheumatology/kev340.
XXVIII. Ibáñez Vodnizza S, Visman IM, van Denderen C, Lems WF, Jaime F, Nurmohamed MT, et al. Muscle wasting in male TNF-α blocker naïve ankylosing spondylitis patients: a comparison of gender differences in body composition. Rheumatology (Oxford). 2017; 56(9):1566-1572. doi: 10.1093/rheumatology/kex187.
XXIX. 27. Rush EC, Goedecke JH, Jennings C, Micklesfield L, Dugas L, Lambert EV, Plank LD. BMI, fat, and muscle differences in urban women of five ethnicities from two countries. Int J Obes (Lond). 2007; 31(8):1232-9. doi: 10.1038/sj.ijo.0803576.
XXX. Karelis AD, St Pierre DH, Conus F, Rabasa-Lhoret R, Poehlman ET. Metabolic and body composition factors in subgroups of obesity: what do we know? J Clin Endocrinol Metab 2004; 89: 2569–75. doi: 10.1210/jc.2004-0165.
XXXI. Gracey E, Yao Y, Green B, Qaiyum Z, Baglaenko Y, Lin A, et al. Sexual Dimorphism in the Th17 Signature of Ankylosing Spondylitis. Arthritis Rheumatol. 2016; 68(3):679-89. doi: 10.1002/art.39464.
XXXII. Huang WN, Tso TK, Kuo YC, Tsay GJ. Distinct impacts of syndesmophyte formation on male and female patients with ankylosing spondylitis. Int J Rheum Dis. 2012; 15(2):163–8.
XXXIII. Mahendira D, Thavaneswaran A, Carty A, Haroon N, Anton A, Passalent L, et al. Analysis of the effect of the oral contraceptive pill on clinical outcomes in women with ankylosing spondylitis. J Rheumatol. 2014; 41(7):1344–8. doi: 10.3899/jrheum.130996.
XXXIV. Jimenez-Balderas FJ, Tapia-Serrano R, Madero-Cervera JI, Murrieta S, Mintz G. Ovarian function studies in active ankylosing spondylitis in women. Clinical response to estrogen therapy. J Rheumatol. 1990; 17(4):497–502. PMID: 2348430.
Publicado
2024-12-30
Cómo citar
1.
Shiomi AL, Tavares AH, Nisihara R, Pereira RR, Skare T. Impacto de la obesidad en la actividad de la enfermedad en pacientes con espondiloartritis axial según el sexo. Rev. Argent. Reumatol. [Internet]. 30 de diciembre de 2024 [citado 21 de febrero de 2025];35(4):93 - 101. Disponible en: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/896
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Derechos de autor 2025 a nombre de los autores. Derechos de reproducción: Sociedad Argentina de Reumatología
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
