Chen, Y and Yu, Z and Packham, JC and Mattey, DL (2013) Influence of adult height on rheumatoid arthritis: association with disease activity, impairment of joint function and overall disability. PLoS One, 8 (5). e64862 -?. ISSN 1932-6203

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Abstract

OBJECTIVES: To investigate whether normal variation of adult height is associated with clinical characteristics in rheumatoid arthritis (RA), including disease activity (DAS28), impairment of joint function (mechanical joint score, MJS) and overall disability (health assessment questionnaire, HAQ). METHODS: A cohort (134 males, 287 females) of consecutively recruited RA patients of Northern European origin was studied. Height, weight and demographic information were obtained. A core set of disease measurements, including DAS28, MJS and HAQ, were recorded at baseline, 12 and 24 months. Other clinical variables (e.g. disease duration, IgM rheumatoid factor, antibodies to cyclic citrullinated peptide, C-reactive protein, erythrocyte sedimentation rate) were recorded at baseline. Socioeconomic status, smoking status, comorbid condition, other autoimmune conditions and drug therapy were also recorded. Associations were analyzed using univariate statistics and multivariate linear regression models. Mediation tests were also carried out for evaluating the relationship between gender, height and disease measures. RESULTS: In males, height was inversely associated with DAS28, MJS and HAQ (at baseline and over 24 months) independent of other factors (e.g. weight, body mass index, age, disease duration, osteoporosis, autoantibodies, erosive disease, joint replacement, steroid use, smoking status, socioeconomic status and comorbid disease). In females, a similar trend was seen but the relationships were non significant. In the whole population, the association of female gender with more active disease and poor function disappeared after adjustment for height. Mediation analysis indicated that height served as a full mediator in the relationship of gender with disease activity and overall disability. Confirmation of these findings was demonstrated in a second RA population (n = 288). CONCLUSION: Adult height is inversely associated with disease activity, impairment of joint function and overall disability in RA, particularly in males. The association of female sex with more severe disease activity and disability appears to be mediated by smaller stature.

Item Type: Article
Additional Information: This is the final published version of the article (version of record). It first appeared online via Public Library of Science at http://dx.doi.org/10.1371/journal.pone.0064862 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Adult, Arthritis, Rheumatoid, Body Height, Demography, Disability Evaluation, Female, Humans, Joints, Male, Middle Aged, Models, Biological, Multivariate Analysis, Regression Analysis, Reproducibility of Results, Sex Characteristics, Treatment Outcome
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
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Depositing User: Symplectic
Date Deposited: 24 Mar 2017 10:00
Last Modified: 24 Mar 2017 10:08
URI: http://eprints.keele.ac.uk/id/eprint/3058

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