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Obesity, weight loss and rheumatic diseases

By combining epidemiologic data from large patients’ cohorts, genetics and in vitro studies we aim to understand the role of adipokines in the development of rheumatoid arthritis, a common inflammatory disease affecting the joints. Adipokines are cell-signalling proteins (cytokines) produced by the adipose tissue and they play an important role in the regulation of metabolism and inflammation. Among them, adiponectin is one of the most well-studied and is highly abundant in serum. Although mostly produced by adipocytes, circulating adiponectin is surprisingly low in subjects with obesity. Adiponectin levels are increased in serum and joint fluids of subjects with rheumatoid arthritis and they correlate with disease activity.

Previous results:
We investigated the effect of bariatric surgery on the risk of developing rheumatic diseases in obese subjects, focusing on gout and psoriatic arthritis. To answer this research question, we exploited the potential of the Swedish Obesity Subjects (SOS) study. The SOS study is a large trial started in the 80’s which includes participants from all over Sweden and its headquarters is set at the University of Gothenburg. The study aims to investigate the effect the effect of bariatric surgery on obesity-associated morbidity and mortality compared to conventional treatment. The trial includes 4047 individuals who have been followed-up for up to 29 years. Prof. Lena Carlsson is the current leader of the SOS study.
Obesity is a major health problem in western countries and its prevalence is increasing in the last decades. Obesity surgery, also known as bariatric surgery, is the most effective way to achieve a sustained weight loss. Overweight and obesity increase the risk of developing several diseases, including rheumatic diseases, leading to a worse quality of life and to increased mortality in affected subjects. Furthermore, obese subjects suffering from rheumatic diseases, such as rheumatoid arthritis and psoriatic arthritis, seem to have a higher disease activity and a lower chance to respond to therapy compared to lean subjects. Obesity is associated with a low-grade systemic inflammation and it has been hypothesized that this mild inflammatory state may trigger the development of rheumatic diseases. However, the specific mechanisms underlying this association are unknown. Moreover, the effect of bariatric surgery on the susceptibility to and the activity of rheumatic diseases, including the response to treatment, is currently poorly understood.

We have recently shown that bariatric surgery decreases the incidence of gout in obese participants of the SOS study followed up for up to 25 years (Maglio C et al, Annals of the Rheumatic Diseases 2017). Gout is a common inflammatory joint disease, characterized by the deposition of uric acid crystals in the joint with subsequent inflammation. We have also shown that obese subjects undergoing bariatric surgery have lower serum uric acid levels and a lower chance to develop hyperuricemia during follow up.
Subjects with obesity are at risk for psoriasis, an inflammatory disease affecting mostly the skin, as well as psoriatic arthritis. We have shown that bariatric surgery associates with a lower incidence of psoriasis in subjects with obesity followed up for up to 26 years (Maglio C et al, Obesity 2017). No significant difference in the risk of developing psoriatic arthritis was detected when comparing subjects who underwent surgery and the control group.

National and international collaborations:
Maglio group works in collaboration with Prof. Anna Rudin’s group at the Dept. of Rheumatology and Inflammation, as well as with Prof. Lena Carlsson’s group, at the Dept. of Molecular and Clinical Medicine, University of Gothenburg. The group has also established national and international collaborations such as with Prof. Solbritt Rantapää Dahlqvist, at the University of Umeå, Prof. Markku Peltonen, at the National Institute for Health and Welfare, Helsinki, Finland, and Prof. Christian Herder, at the University of Düsseldorf, Germany.

Cristina Maglio


Cristina Maglio

Box 480, 405 30 Göteborg

Guldhedsgatan 10A

+46 73 323 14 85

Sidansvarig: kommunikation@medicine.gu.se|Sidan uppdaterades: 2019-01-22

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