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Obesity induces a proinflammatory state and is a major cause of morbidity in the general population. However, little is known about the effects of obesity in patients with chronic inflammatory illnesses such as systemic lupus erythematosus (SLE).One hundred consecutive patients with SLE were studied to determine the relationship between body mass index (BMI) and functional capacity, measures of fatigue, quality of life, and the inflammation markers C‐reactive protein (CRP), the erythrocyte sedimentation rate, and interleukin‐6 (IL‐6). The association between BMI and patient characteristics was determined, and multiple logistic regression models were used to adjust for age, sex, disease activity, and disease‐related damage.Thirty‐three patients had a normal BMI (<25 kg/m2), 28 were overweight (25–29.9 kg/m2), and 39 were obese (≥30 kg/m2). Obese patients had worse functional capacity, more fatigue, and higher concentrations of inflammation markers. The mean ± SD modified Health Assessment Questionnaire (M‐HAQ) score was 0.6 ± 0.4 in obese patients compared with 0.3 ± 0.4 and 0.2 ± 0.3 in overweight patients and those with a normal BMI, respectively (P = 0.001). The mean ± SD concentrations of CRP in obese patients (10.0 ± 8.6 mg/liter) were higher than those in patients who were overweight (4.7 ± 5.4 mg/liter) or had a normal BMI (6.2 ± 9.9 mg/liter) (P < 0.001). Similarly, concentrations of IL‐6 were higher in obese patients (P = 0.003). After adjusting for age, sex, disease activity, and damage indices, the associations between BMI and CRP (P < 0.001), M‐HAQ scores (P = 0.005), and IL‐6 concentrations (P = 0.01) remained significant.Obesity is independently associated with impaired functional capacity and inflammation markers in patients with lupus. Thus, weight loss may improve functional capacity and decrease cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

To compare the prevalence and severity of coronary‐artery atherosclerosis in patients with early and established rheumatoid arthritis (RA) and controls.Electron‐beam computed tomography was used to measure the extent of coronary‐artery calcification in 227 subjects, of whom 70 had early RA, 71 had established RA, and 86 were controls. Coronary‐artery calcification calculated according to the Agatston calcium score was compared in patients and controls, and its relationship to clinical characteristics was examined. Adjusted odds ratios (ORs) were obtained with the use of proportional odds logistic regression models to determine independent associations of early and established RA and coronary‐artery calcification.Calcium scores were higher in patients with established RA (median 40.2, interquartile range [IQR] 0–358.8) compared with those with early disease (median 0, IQR 0–42.6) and controls (median 0, IQR 0–19.2) (P = 0.001). Coronary‐artery calcification occurred more frequently in patients with established RA (60.6%) than in patients with early RA (42.9%) and control subjects (38.4%) (P = 0.016) The OR for the likelihood of having more severe coronary‐artery calcification (defined as an Agatston score >109) in patients with established disease was 3.42 (P = 0.002) after adjusting for cardiovascular risk factors. Among patients with RA, smoking (OR 1.02, P = 0.04) and an elevated erythrocyte sedimentation rate (OR 1.02, P = 0.05) were associated with more severe coronary‐artery calcification after adjustment for age and sex.The prevalence and severity of coronary calcification is increased in patients with established RA and is related, in part, to smoking and an increased erythrocyte sedimentation rate. [ABSTRACT FROM AUTHOR]