Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

  • Conditions
    • Axial Spondyloarthritis
    • Gout and Crystalline Arthritis
    • Myositis
    • Osteoarthritis and Bone Disorders
    • Pain Syndromes
    • Pediatric Conditions
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Sjögren’s Disease
    • Systemic Lupus Erythematosus
    • Systemic Sclerosis
    • Vasculitis
    • Other Rheumatic Conditions
  • FocusRheum
    • ANCA-Associated Vasculitis
    • Axial Spondyloarthritis
    • Gout
    • Psoriatic Arthritis
    • Rheumatoid Arthritis
    • Systemic Lupus Erythematosus
  • Guidance
    • Clinical Criteria/Guidelines
    • Ethics
    • Legal Updates
    • Legislation & Advocacy
    • Meeting Reports
      • ACR Convergence
      • Other ACR meetings
      • EULAR/Other
    • Research Rheum
  • Drug Updates
    • Analgesics
    • Biologics/DMARDs
  • Practice Support
    • Billing/Coding
    • EMRs
    • Facility
    • Insurance
    • QA/QI
    • Technology
    • Workforce
  • Opinion
    • Patient Perspective
    • Profiles
    • Rheuminations
      • Video
    • Speak Out Rheum
  • Career
    • ACR ExamRheum
    • Awards
    • Career Development
  • ACR
    • ACR Home
    • ACR Convergence
    • ACR Guidelines
    • Journals
      • ACR Open Rheumatology
      • Arthritis & Rheumatology
      • Arthritis Care & Research
    • From the College
    • Events/CME
    • President’s Perspective
  • Search

Obesity’s Effects on Inflammatory Markers in Patients with RA

Arthritis Care & Research  |  November 29, 2017

Laboratory measures of systemic inflammation, particularly C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR), are routinely used in the diagnosis and assessment of disease activity in patients with rheumatoid arthritis (RA). Prior research has associated higher levels of CRP with greater body mass index (BMI) and adiposity in the general population, especially among women. This association may indicate that these inflammatory markers may perform as a biomarker of disease activity among obese patients with RA.

To assess this possibility, Michael D. George, MD, MSCE, from the University of Pennsylvania, Philadelphia, and colleagues designed a study to evaluate the connection between BMI and inflammatory markers in people with RA, determine if these associations are similar to patients without RA and examine the potential effect of obesity on disease activity. Their findings were published in December 2017 Arthritis Care & Research.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Using data that from two RA cohorts, the cross-sectional Body Composition (BC) cohort and the longitudinal Veterans Affairs Rheumatoid Arthritis (VARA) registry, researchers identified 2,103 patients with RA. For comparison, researchers used data from the National Health and Nutrition Examination Survey to evaluate the general population.

The Results
“Obesity was associated with higher CRP levels in women with RA,” write the authors in their discussion. “A similar association was observed in a non-RA sample, suggesting that elevated CRP level values among obese women with RA are not reflective of greater RA disease activity, but rather are an expected phenomenon related to adiposity. In contrast …, low BMI and not obesity was associated with higher CRP levels in men with RA.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

In women, both with and without RA, BMI was positively associated with CRP levels. Women with RA in higher BMI categories had higher predicted CRP levels—particularly for severely obese women. Additionally, DXA-measured fat mass was strongly associated with CRP levels, and adjustment for fat mass completely attenuated the association between BMI and CRP level, suggesting that higher CRP levels among women with RA and elevated BMI are due to increased adiposity. When examining ESR, researchers also observed higher ESRs in higher BMI categories in women with and without RA. However, only severely obese women in one RA cohort had significantly higher ESRs compared with normal-weight women.

Researchers note, “A higher BMI was not associated with greater swollen joint count, tender joint count or patient global health score in women with RA in similar analyses, and the positive association between BMI and CRP level among women with RA was not attenuated with adjustment for swollen joint count, tender joint count and patient global health scores.”

Page: 1 2 | Single Page
Share: 

Filed under:ConditionsResearch RheumRheumatoid Arthritis Tagged with:Arthritis Care & Researchbody mass index (BMI)C-reactive protein (CRP)erythrocyte sedimentation rate (ESR)ObesityRheumatoid Arthritis (RA)

Related Articles

    Mechanistic, Epidemiologic Clues Suggest Possible Link Between Obesity, Inflammation in Rheumatoid Arthritis

    October 11, 2016

    Obesity has an established systemic inflammatory component. Could that be a trigger for the inflammation seen in rheumatoid arthritis (RA) and other rheumatic diseases? Although there is no direct scientific evidence, both mechanistic and epidemiologic clues do give some intriguing suggestions of a possible link. “At first, we thought that fat was involved only in…

    Obesity Associated with Increased Inflammatory Markers in Rheumatoid Arthritis

    April 13, 2017

    NEW YORK (Reuters Health)—Obesity and higher fat mass are associated with increased levels of inflammatory markers in women with rheumatoid arthritis (RA), researchers report. “Physicians should recognize that C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are affected by obesity in patients with and without rheumatoid arthritis, especially in women,” Dr. Michael D. George from the University of…

    Gout, Glucose Metabolism and Obesity: A Case Review

    November 2, 2014

    New research explores association between hyperurecimia and gout with metabolic derangement

    Psoriatic Arthritis & the Obese Patient

    November 6, 2022

    Estimates from the National Psoriasis Foundation indicate that more than 8 million people in the U.S. suffer from psoriasis and that approximately 30% of those individuals develop psoriatic arthritis (PsA).1 Given these statistics, roughly 2.4 million people in the country are likely affected by PsA. Moreover, patients with this systemic condition carry a higher-than-average burden…

  • About Us
  • Meet the Editors
  • Issue Archives
  • Contribute
  • Advertise
  • Contact Us
  • Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 1931-3268 (print). ISSN 1931-3209 (online).
  • DEI Statement
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences