Ankilozan Spondilitli Bireylerde Obezitenin Etkisi: Tek Merkezli Kohort Çalışması

Öz

Amaç: Bu çalışmanın amacı Ankilozan Spondilitli (AS) bireylerin hastalık aktivitesini ve fonksiyonel durumlarını vücut kütle indeksine (VKİ) göre karşılaştırmaktır. Gereç ve Yöntemler: Tek merkezli kohort çalışması olarak planlanan bu çalışmaya, AS tanılı 437 birey dahil edildi. Hastalık aktiviteleri Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), fonksiyonel düzeyleri ise Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFI) ile değerlendirildi. Katılımcılar, Dünya Sağlık Örgütü'nün kriterlerine dayanarak VKİ verilerine göre 3 gruba ayrıldı: normal ağırlık:20-24,9; fazla kilolu: 25-29,9; obez:≥30. Bağımsız grup farklılıklarının karşılaştırılmasında One Way Anova Testi, Kruskal Wallis Testi, Mann Whitney U testi ve Ki-Kare Testi kullanıldı. BASDAI, BASFI (bağımlı değişkenler) ve VKİ kategorileri (bağımsız değişkenler) arasındaki ilişkiyi tanımlamak için doğrusal regresyon modelleri kullanıldı. Tek değişkenli regresyon analizleri yapıldı (modelde yalnızca bir bağımsız değişken). Bulgular: AS'li 437 hastanın % 30.2’i normal ağırlıkta, %39,5'i fazla kilolu, %30,2'i ise obezdir. UKİ grupları arasındaki verilerin analiz sonuçlarında; BASFI'de (p=0,001) obez grup lehine anlamlı fark vardı. BASFI için ikili grup karşılaştırmalarında; normal ile obez (p=0,002) ve fazla kilolu ile obez (p=0,001) arasında obez grup lehine anlamlı fark vardı. Ortak değişkenler için düzeltme yapılmadan normal ağırlıklı grupla karşılaştırıldıklarında, obezite daha yüksek BASFI skoru ile anlamlı düzeyde ilişkiliydi (β:-0,37, %95CI -0,66/-0,08, p=0,006). Öte yandan, BASDAI ile obezite arasında herhangi bir ilişki yoktu (β:-0,50, 95%CI -1,11/ 1,22, p:0,130). Sonuç: Tek merkezli bir kohorttaki, Türk AS’li bireylerin VKİ’nin hastalık aktivitesi üzerine etkisi yoktu, ancak obezite fonksiyonel düzey üzerinde daha kötü bir etkiye sahip idi.

Anahtar Kelimeler

• Ankilozan spondilit
• Vücut kütle indeksi
• Fazla kilo
• Hastalık

The Effect of Obesity in Individuals with Ankylosing Spondylitis: A Single Center Cohort Study

Öz

Aim: The aim of this study was to compare the disease activity and functional status of individuals with Ankylosing Spondylitis (AS) according to body mass index (BMI). Material and Methods: This study, which was planned as a single-center cohort study, included 437 individuals with AS. Disease activities were evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and functional levels with the Bath Ankylosing Spondylitis Functional Index (BASFI). Participants were categorized in 3 groups according to BMI data based on the criteria of the World Health Organization: normal weight:20-24.9; overweight: 25-29.9; obese:≥30. One Way Anova Test, Kruskal Wallis Test, Mann Whitney U test and Chi-Square Test were used to compare independent group differences. Linear regression models were used to describe the relationship between BASDAI, BASFI (dependent variables) and BMI categories (independent variables). Univariate regression analyses were performed (only one independent variable in the model). Results: Among 437 patients with AS, 30.2% are normal weight, 39.5% are overweight and 30.2% are obese. Analysis results of data between BMI groups; significant difference was in BASFI (p=0.001) in favor of the obese group. In binary group comparisons for BASFI; there was a significant difference in favor of the obese group between normal and obese (p=0.002) and between overweight and obese (p=0.001). Obese was significantly associated with higher BASFI score compared to the normal weight group without adjustment for covariates (β:-0.37, 95%CI -0.66/-0.08, p=0.006). On the other hand, there was no association between BASDAI and obesity (β:-0.50, 95%CI -1.11/ 1.22, p:0.130). Conclusion: The BMI of Turkish AS individuals in a single center cohort had no effect on disease activity, but obesity had a worse effect on functional level.

Anahtar Kelimeler

• Ankylosing spondylitis
• Body mass index
• Overweight
• Disease

Kaynakça

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