这项横断面研究纳入了来自格罗宁根吕伐登中轴型脊柱关节病队列在2011/2012年门诊就诊的患者。对患者的体重、身高、疾病活动度、物理功能和生活质量（Qol）进行评估。将患者分为正常体重（体重指数＜25kg/m2）、超重（25≤体重指数＜30kg/m2）和肥胖（体重指数≥30kg/m2）组。从生命线队列研究中获取在同一人口地区年龄和性别匹配的一般人群的体重指数数据。

461例中轴型脊柱关节病患者中，37%患者超重，22%患者肥胖。在生命线队列（n=136577例）中，43%患者超重，15%患者肥胖。超重和肥胖的患者年龄较大，病程更长且有更多的合并症，尤其是高血压。此外，肥胖患者与超重和体重正常的患者相比，疾病活动度显著升高、物理功能更差且生活质量更差（平均巴氏强直性脊柱炎疾病活动指数分别为4.5、3.5和3.8；平均强直性脊柱炎疾病活动评分分别为2.8、2.2和2.3；平均C反应蛋白水平分别为5、3和3mg/l；平均红细胞沉降率13、8和8mm/hl；平均巴氏强直性脊柱炎功能指数5.2、2.9和2.9；平均强直性脊柱炎生活质量问卷8、4和5）。调整潜在的混杂因素后，肥胖是临床预后差的独立预测因素。

在这项大型观察队列研究中，与一般人群相比中轴型脊柱关节病患者肥胖更常见，且与临床预后不佳相关。

OBJECTIVE: To assess the prevalence of overweight and obesity in a large cohort of patients with axial spondyloarthritis (axSpA) in comparison with the general population. To explore the relationship of body mass index (BMI) with clinical outcome in axSpA. METHODS: Patients from the Groningen Leeuwarden Axial SpA cohort who visited the outpatient clinic in 2011/2012 were included in this cross-sectional analysis. Body weight, height, disease activity, physical function, and quality of life (QoL) were assessed. Patients were divided into normal weight (BMI < 25 kg/m2), overweight (BMI ≥ 25 to < 30 kg/m2), and obese (BMI ≥ 30 kg/m2). BMI data for the general population in the same demographic region, matched for age and sex, were obtained from the LifeLines Cohort Study. RESULTS: Of the 461 patients with axSpA, 37% were overweight and 22% were obese. In the LifeLines cohort (n = 136,577), 43% were overweight and 15% were obese. Overweight and obese patients were older, had longer symptom duration, and had more comorbidities, especially hypertension. Further, obese patients had significantly higher disease activity, worse physical function, and worse QoL than overweight and normal weight patients (mean Bath Ankylosing Spondylitis Disease Activity Index 4.5, 3.5, 3.8; mean Ankylosing Spondylitis Disease Activity Score 2.8, 2.2, 2.3; median C-reactive protein 5, 3, 3 mg/l; median erythrocyte sedimentation rate 13, 8, 8 mm/h; median Bath Ankylosing Spondylitis Functional Index 5.2, 2.9, 2.9; median Ankylosing Spondylitis QoL Questionnaire 8, 4, 5, respectively). After adjustment for potential confounders, obesity proved to be an independent predictor of worse clinical outcome. CONCLUSION: In this large observational cohort study, obesity is more common in axSpA than in the general population and it is associated with worse clinical outcome.

Maas F, Arends S, van der Veer E, Wink F, Efde M, Bootsma H, Brouwer E, Spoorenberg A. Obesity Is Common in Axial Spondyloarthritis and Is Associated with Poor Clinical Outcome. J Rheumatol. 2015 Dec 15. pii: jrheum.150648. [Epub ahead of print]