Review Article

Body Mass Index and the Risk of Rheumatoid Arthritis: An Updated Dose-Response Meta-Analysis

Table 1

Characteristics of included studies.

Author (year)countrystudy designAgeGenderNOSSample sizeMethod of weight/heightBMI categoryOR(RR)(95%CI)Adjustment factors
RA/Control(kg/m2)MenWomen

Voigt, 1994USACase-control18-64Women7349/1457Self-reportedpremenopausalNAAge, smoking status
12.94-20.431.00
20.44-22.511.10(0.70-1.60)
22.52-25.821.00(0.70-1.60)
25.83-52.861.50(1.00-2.30)
postmenopausal
12.94-20.431.00
20.44-22.511.10(0.50-2.10)
22.52-25.821.40(0.70-2.60)
25.83-52.861.40(0.70-2.60)

Symmons, 1997UKCase-control18-70Mixed790/93Self-reported20.0-24.9Mixed1.00Smoking status, social class
25.0-29.91.08(0.54-2.16)
30.0 -40.03.74(1.14-12.27)

Uhlig, 1999NorwayCase-control20-79Mixed7347/5725Self-reported<25.0Mixed1.00Age, sex, marital status, employment category, formal education, current smoking status.
25.0-29.91.09(0.80-1.48)
≥30.01.54(0.91-2.58)

Pedersen, 2006DenmarkCase-control18-65Mixed6505/752Self-reported<18.50.95(0.19-4.72)0.95(0.52-1.73)Birth year, year of RA diagnosis, gender
18.5-25.01.001.00
25.0-30.00.86(0.54-1.37)1.26(0.87-1.85)
>30.01.39(0.71-2.71)1.83(0.97-3.44)

Rodriguez, 2009UKCase-control20-79Mixed8559/4234Measured<20.0Mixed0.65(0.43-0.98)Age, sex, calendar year, number of referrals, and visits to a primary care physician
20.0-24.91.00
25.0-30.01.18(0.94-1.98)
>300.95(0.68-1.34)

Wesley, 2013SwedenCase-control18-70Mixed72748/3444Self-reportedACPA-PositiveSex, age, area of residence, smoking,
alcohol consumption, education
<25.01.001.00
25.0-30.01.10(0.70-1.80)1.00(0.80-1.20)
≥30.00.60(0.30-0.90)1.00(0.80-1.20)
ACPA-Negative
<25.01.001.00
25.0-30.01.00(0.70-1.40)1.10(0.70-1.60)
≥30.01.10(0.60-1.80)1.60(1.20-2.20)

Crowson, 2013USACase-control≥18Mixed5813/813Measured<30.0Mixed1.00Age, sex and calendar year, smoking status
≥30.01.22(0.99-1.49)

Ljung, 2016SwedenCase-control25-74Mixed7557/1671Measured<25.01.001.00Smoking habits, educational level, age, sex, year of health examination, cohort
25.0-30.01.29(0.84-1.96)1.21(0.92-1.59)
≥30.01.78(1.01-3.12)1.37(0.96-1.95)

Turesson, 2016SwedenCase-control58 ± 7.2Mixed8MDCS (172/688)MeasuredMDCSSmoking, level of formal education, alcohol consumption, socio-economic status
18.5-25.01.001.00
25.0-30.00.44(0.15-1.29)0.96(0.57-1.61)
>30.00.14(0.01-1.44)0.96(0.48-1.92)
MPMP (290/1160)MPMP
18.5-25.01.001.00
25.0-30.00.75(0.46-1.20)1.67(0.94-2.69)
>30.00.64(0.20-2.02)0.90(0.36-2.26)

Fu, 2017ChinaCase-control18-75Mixed7400/400Self-reported<23.9Mixed1.00Sex
>24.01.26(0.95-1.66)

Wei, 2018ChinaCase-control30-75Mixed7403/128Self-reported<25.0Mixed1.00Age, sex, waist circumference, erosive osteoarthritis, duration of disease, current smoker,
25.0-30.00.88(0.53-1.46)
≥30.01.02(0.55-1.88)

Heliovaara, 1993FinlandCohort30-69Men928364Measured<25.01.00NASmoking, geographical region, type of population, marital status, social class, perceived, health, and age
25.0-30.00.80(0.50-1.20)
>30.00.40(0.20-1.20)

Cerhan, 2002USACohort55-69Women731336Self-reported<23.4NA1.00Age
23.4-25.80.88(0.56-1.37)
25.9-29.20.99(0.64-1.53)
>29.21.01(0.65-1.56)

Harpsoe, 2014DenmarkCohort27.4-33.3Women775008Self-reported<18.5NA0.82(0.45-1.50)Smoking status, alcohol consumption, parity, socio-occupational status
18.5-25.01.00
25.0-30.01.12(0.85-1.49)
≥30.01.53(1.07-2.18)

Lahiri, 2014UKCohort40-79Mixed925455Self-reported<25.0Mixed1.00Age, gender, smoking status, breastfeeding, alcohol consumption
25.0-30.01.16(0.78-1.74)
>30.01.49(0.91-2.42)

Lu, 2014USACohortNHS: 30-55Women7NHS:109896MeasuredNHSAge, community median income, smoking status, alcohol consumption, physical activity, parity, breastfeeding status, postmenopausal use, postmenopausal Hormone use
18.5-24.9NA1.00
25.0-29.91.16(0.99-1.35)
≥30.01.12(0.92-1.37)
NHSII: 25-42NHS2:108727NHSII
18.5-24.9NA1.00
25.0-29.91.68(1.30-2.17)
≥30.01.72(1.31-2.45)

BMI, body mass index; RR, relative risk; CI, confidence interval; NA, not available; M, men; W, women; NOS, New castale-Ottawa Scale; NHS, Nurses’ Health Study.