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Review
. 2014 Nov 11:5:576.
doi: 10.3389/fimmu.2014.00576. eCollection 2014.

Obesity as a risk and severity factor in rheumatic diseases (autoimmune chronic inflammatory diseases)

Elisa Gremese  1 , Barbara Tolusso  1 , Maria Rita Gigante  1 , Gianfranco Ferraccioli  1
Affiliations
Review

Obesity as a risk and severity factor in rheumatic diseases (autoimmune chronic inflammatory diseases)

Elisa Gremese et al. Front Immunol. .

Abstract

The growing body of evidence recognizing the adipose tissue (AT) as an active endocrine organ secreting bioactive mediators involved in metabolic and inflammatory disorders, together with the global epidemic of overweight and obesity, rise obesity as a hot topic of current research. The chronic state of low-grade inflammation present in the obese condition and the multiple pleiotropic effects of adipokines on the immune system has been implicated in the pathogenesis of several inflammatory conditions including rheumatic autoimmune and inflammatory diseases. We will discuss the main relevant evidences on the role of the AT on immune and inflammatory networks and the more recent evidences regarding the effects of obesity on the incidence and outcomes of the major autoimmune chronic inflammatory diseases.

Keywords: adipokines; body mass index; inflammation; obesity; rheumatic diseases; rheumatoid arthritis.

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Figures

Figure 1
Figure 1
Distribution of BMI categories among an Italian cohort of adult autoimmune disease patients. In our tertiary referral centre, the prevalence of overweight [defined according to the WHO International standards as a body mass index (BMI) of 25–29.9] or obesity (BMI ≥30) is similar between the different autoimmune disease categories. The graph summarized data from an early-rheumatoid arthritis (early-RA) cohort of patients (N = 401, 76.3% female, mean age: 54.6 ± 14.0 years, mean BMI of 25.3 ± 4.4 Kg/m2), a Spondyloarthritis (SpA) cohort (N = 220, 30.6% female, mean age: 39.5 ± 11.8 years, mean BMI of 25.1 ± 4.4 Kg/m2), a Systemic Lupus Erythematosus (SLE) cohort (506 patients, 90.3% female, mean age: 44.1 ± 14.8 years, mean BMI of 24.0 ± 4.6 Kg/m2), a Systemic Sclerosis (SSc) cohort (442 patients, 88.2% female, mean age: 58.5 ± 14.2 years, mean BMI of 24.4 ± 4.8 Kg/m2), and a primary Sjogren Syndrome (pSS) cohort (204 patients, 96.1% female, mean age: 56.4 ± 14.3 years, mean BMI of 24.3 ± 4.3 Kg/m2) (10). Data are reported as percentage (%) of normal weight, overweight, and obesity in the different diseases.
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