OBJECTIVE polymyalgia rheumatica (PMR) is an inflammatory disorder of the elderly characterized by girdle pain and stiffness. Obesity has an influence on disease activity and outcome in rheumatic diseases like osteoarthritis and rheumatoid arthritis, but its relationship to the severity and outcome of PMR is unknown. METHODS In a post-hoc analysis, 83 patients with recent-onset PMR were studied over six months with clinical examination, laboratory evaluation, and girdle ultrasound. MHAQ, Short Form 36 (SF36), and PMR-VAS, as well as prednisone (PDN) therapy were recorded. Patients were divided according to their body mass index (BMI). RESULTS at baseline, the 12 obese patients had significantly more shoulder pain (p=0.03), global pain (p=0.03), PMR VAS (p<0.01), and fatigue (p=0.03), higher MHAQ (p=0.01), and lower physical component summary on SF36 (p=0.048), SF36 social functioning index (p=0.05) and SF36 pain index (p<0.001). The mean initial PDN dose was similar among groups, but obese patients received a lower dose per kg weight (1.9±0.7 mg vs. 2.2±0.7 mg; p<0.01). At six months, obese patients were being treated with higher mean daily PDN doses (8.5±3.2 mg/day vs. 6.2±5.2 mg/day, p=0.02); 40% of them were receiving higher daily PDN dose than per-protocol, vs. 14% non-obese patients (p=0.048). Clinical features, laboratory and ultrasound results were similar. CONCLUSION obesity affects both symptoms severity and PDN utilization in patients with PMR. The reason thereof may relate to different subjective pain perception rather than increased inflammation in obese patients. BMI should be considered when interpreting symptoms in PMR patients and deciding their PDN doses.

中文翻译：

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患有风湿性多肌痛的肥胖患者在发病时会经历更多的疼痛和残疾，并且需要更高剂量的糖皮质激素。


目的 风湿性多肌痛 （PMR） 是一种以束带疼痛和僵硬为特征的老年人炎症性疾病。肥胖对骨关节炎和类风湿性关节炎等风湿性疾病的疾病活动和结果有影响，但其与 PMR 的严重程度和结果的关系尚不清楚。方法 在事后分析中，对 83 例近期发作的 PMR 患者进行了为期六个月的研究，包括临床检查、实验室评估和腰带超声。记录 MHAQ 、 Short Form 36 （SF36） 和 PMR-VAS 以及泼尼松 （PDN） 治疗。根据患者的体重指数 （BMI） 对患者进行分组。结果 基线时，12 例肥胖患者肩痛 （p=0.03） 、整体疼痛 （p=0.03） 、PMR VAS （p<0.01） 和疲劳 （p=0.03） 显著增加，MHAQ 升高 （p=0.01），SF36 身体成分总结 （p=0.048） 、SF36 社会功能指数 （p=0.05） 和 SF36 疼痛指数 （p<0.001）。各组平均初始 PDN 剂量相似，但肥胖患者每公斤体重接受的剂量较低 （1.9±0.7 mg vs. 2.2±0.7 mg;p<0.01）。在 6 个月时，肥胖患者接受更高的平均每日 PDN 剂量治疗 （8.5±3.2 mg/天 vs. 6.2±5.2 mg/天，p = 0.02）;其中 40% 的患者接受的每日 PDN 剂量高于方案，而非肥胖患者为 14% （p=0.048）。临床特征、实验室和超声结果相似。结论 肥胖影响 PMR 患者的症状严重程度和 PDN 利用率。其原因可能与肥胖患者不同的主观疼痛感知有关，而不是炎症增加。在解释 PMR 患者的症状和决定他们的 PDN 剂量时，应考虑 BMI。