超重对强直性脊柱炎患者报告结局及临床指标的影响

Impact of overweight on patient-reported outcomes and clinical indices in ankylosing spondylitis patients

目的 探讨强直性脊柱炎(AS)患者的超重率,以及体质指数(BMI)异常增高对患者报告结局(PROs)及临床指标的影响。方法 纳入2017年2月至2019年8月南通大学附属医院确诊的AS患者185例,根据入组时测得的BMI分为BMI正常组(n=74)和超重组(n=111)。比较两组患者的一般资料、PROs及临床指标,采用Pearson相关或Spearman相关分析BMI与其他指标的相关性,采用线性回归分析脊柱活动性的影响因素。结果 AS患者的超重率为60%。与BMI正常组相比,超重组多为已婚、年龄大、腰围大、腰臀比高、病程长、Bath强直性脊柱炎计量指数(BASMI)得分高、淋巴细胞及血小板计数多,差异有统计学意义(P<0.05)。年龄(r=0.258,P<0.001)、腰围(r=0.673,P<0.001)、腰臀比(r=0.407,P<0.001)、BASMI(r=0.168,P=0.026)以及淋巴细胞计数(r=0.210,P=0.007)与BMI呈正相关。多元线性回归分析结果显示年龄(β=0.434,P<0.001)、总体痛(β=0.427,P=0.005)、C反应蛋白(β=0.337,P=0.021)以及超重(β=0.315,P=0.006)是BASMI的影响因素。结论 超重在AS患者中常见,影响患者的脊柱活动性及血细胞计数。

Objective To study the prevalence of overweight and to explore the effect of abnormal increase of body mass index(BMI)on patient-reported outcomes(PROs)and clinical indices in ankylosing spondylitis(AS)patients. Methods A total of 185 patients diagnosed with AS in the Affiliated Hospital of Nantong University from Feb. 2017 to Aug. 2019 were enrolled and categorized to normal BMI group(n=74)and overweight group(n=111)according to the BMI measured at the time of enrollment. Sociodemographic data,PROs and clinical indices of the two groups were compared,Pearson correlation or Spearman correlation was used to analyze the association between BMI and other indices,and linear reggression was used to analyze the influencing factors of spinal mobility. Results Among Among the 185 AS patients,60% were overweight. In the overweight group,patients were more likely to be married,older,with higher waist circumference,higher waist-to-hip ratio,longer disease duration,higher Bath Ankylosing Spondylitis Metrology Index score(BASMI),higher lymphocyte and higher platelet count(P<0.05),as compared to the normal BMI group. Age(r=0.258,P<0.001),waist circumference(r=0.673,P<0.001),waist-to-hip ratio(r=0.407,P<0.001),BASMI(r=0.168,P=0.026)and lymphocyte count(r=0.210,P=0.007)were found to be positively associated with BMI. Multiple linear regression results showed that age(β=0.434,P<0.001),global pain(β=0.427,P=0.005),C-reactive protein(β=0.337,P=0.021)and overweight(β=0.315,P=0.006)were the influencing factors of BASMI. Conclusion Overweight is common in AS patients,impacting patients in spinal mobility and blood cell count.