The Relationship Between Obesity and Patient-Reported Outcome Measures in People with Polymyalgia Rheumatica

Scott, Ian C; Bajpai, Ram; Hider, Samantha L; Helliwell, Toby; Mallen, Christian D; Muller, Sara

Abstract

Objective
To examine the association between obesity and patient-reported outcomes measures (PROMs) in a primary care-based cohort of people with polymyalgia rheumatica (PMR).

Methods
The PMR Cohort Study recruited people with incident PMR from 382 general practices. Self-completed questionnaires (0, 12, 24-months) captured a range of PROMs for pain, stiffness, anxiety, depression, fatigue, function, and quality of life, alongside data on body mass index (BMI). People were categorised as underweight/normal weight (BMI < 25kg/m2), overweight (25 to 29.99 kg/m2), or obese (≥30 kg/m2). Piecewise, multilevel, linear mixed-effects regression models examined relationships between BMI categories and PROMs over time, adjusting for confounding variables. Chi-squared tests examined the relationship between obesity and glucocorticoid persistence.

Results
644 people with PMR were included. At baseline 33.9% were normal/under-weight, 40.6% overweight, and 25.5% obese. Compared with normal/underweight people, those with obesity had significantly worse scores for the following: pain and stiffness at 12-months; fatigue at 12- and 24-months; depression at baseline; physical function at all time-points; quality of life at baseline and 12-months. They also had significantly smaller improvements in stiffness (1.13 units on an 11-point numeric rating scale; p = 0.001) and physical function (0.14 units measured using the modified Health Assessment Questionnaire; p = 0.025) between 0 to 12-months. BMI categories did not relate to persistent glucocorticoid use at 12-months (p = 0.110) or 24-months (p = 0.166).

Conclusion
Obesity associates with poorer outcomes for a range of PROMs in people with PMR. Consideration should be given to providing weight management support to people with PMR and obesity.

Citation

Scott, I. C., Bajpai, R., Hider, S. L., Helliwell, T., Mallen, C. D., & Muller, S. (in press). The Relationship Between Obesity and Patient-Reported Outcome Measures in People with Polymyalgia Rheumatica. Rheumatology Advances in Practice, 8(3), Article rkae081. https://doi.org/10.1093/rap/rkae081

• Journal Article Type: Article
• Acceptance Date: Apr 29, 2024
• Online Publication Date: Jul 5, 2024
• Deposit Date: Jul 8, 2024
• Publicly Available Date: Jul 15, 2024
• Journal: Rheumatology Advances in Practice
• Print ISSN: 2514-1775
• Electronic ISSN: 2514-1775
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 3
• Article Number: rkae081
• DOI: https://doi.org/10.1093/rap/rkae081
• Keywords: Polymyalgia rheumatica, body mass index, obesity, patient-reported outcome measures
• Public URL: https://keele-repository.worktribe.com/output/872288
• Publisher URL: https://academic.oup.com/rheumap/advance-article/doi/10.1093/rap/rkae081/7708407