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. We aimed to investigate the relationship between high BMI and the severity and outcome of PMR, which is incompletely understood. METHODS In a post hoc analysis, 83 patients with recent-onset PMR were studied over 6 months using clinical examination, laboratory evaluation, and girdle ultrasound (US). The modified Health Assessment Questionnaire (mHAQ), 36-item Short Form Health Survey (SF-36), and PMR visual analog scale (VAS) scores, as well as prednisone therapy data, were recorded. Patients were grouped according to their BMI. RESULTS At baseline, the 12 patients with obesity 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 SF-36 physical component summary (P = 0.048) and SF-36 pain index (P < 0.001). The mean initial prednisone dose was similar among groups, but patients with obesity received a lower dose/kg (1.9 [SD 0.7] mg vs 2.2 [SD 0.7] mg; P < 0.01). At 6 months, patients with obesity were being treated with higher mean daily prednisone doses (8.5 [SD 3.2] mg/d vs 6.2 [SD 5.2] mg/d; P = 0.02), and 40% of them were receiving higher daily prednisone doses than the standard protocol compared with 14% patients without obesity (P = 0.048). Clinical features, laboratory results, and US results were similar between patients with and without obesity. CONCLUSION Obesity affects both symptom severity and prednisone utilization in patients with PMR. The reason for this may relate to different subjective pain perception rather than increased inflammation in patients with obesity. BMI should be considered when interpreting symptoms in patients with PMR and deciding their prednisone doses.

中文翻译：

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风湿性多肌痛和肥胖患者的症状严重程度和糖皮质激素剂量。


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。肥胖会影响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。我们旨在调查高 BMI 与 PMR 的严重程度和结果之间的关系，目前尚不完全清楚。方法 在事后分析中，使用临床检查、实验室评估和腰带超声 （US） 对 83 例新发 PMR 患者进行了 6 个月的研究。记录改良的健康评估问卷 （mHAQ） 、 36 项简短健康调查 （SF-36） 和 PMR 视觉模拟量表 （VAS） 评分，以及泼尼松治疗数据。根据患者的 BMI 对患者进行分组。结果 基线时，12 例肥胖患者的肩痛 （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;更高的 mHAQ （P = 0.01）;和较低的 SF-36 物理成分总结 （P = 0.048） 和 SF-36 疼痛指数 （P < 0.001）。各组平均泼尼松初始剂量相似，但肥胖患者接受的剂量较低/kg（1.9 [SD 0.7] mg vs 2.2 [SD 0.7] mg;P < 0.01）。在 6 个月时，肥胖患者接受更高的平均每日泼尼松剂量治疗（8.5 [SD 3.2] mg/d vs 6.2 [SD 5.2] mg/d;P = 0.02），其中 40% 的患者接受的每日泼尼松剂量高于标准方案，而 14% 的患者没有肥胖 （P = 0.048）。肥胖和非肥胖患者的临床特征、实验室结果和 US 结果相似。结论 肥胖影响 PMR 患者的症状严重程度和泼尼松的使用。 造成这种情况的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 患者的症状和决定泼尼松龙剂量时，应考虑 BMI。