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The relation of body image perception with body mass index, gender and disease activity in ankylosing spondylitis and rheumatoid arthritis

Tuba Tulay Koca, Hasan Gogebakan, Gozde Yildirim Cetin.

Aim: Ankylosing spondylitis (AS) and Rheumatoid arthritis (RA) are chronic inflammatory joint diseases that can lead physical deformities at peripheral joints. Both physical deformities and chronic pain can lead to psychological changes in people due to impairment in the body image perception (BIP) of the body.
Material and methods: Sixty (N=60) AS patients and 55 RA patients were included into the study. Age, gender, body mass index (BMI), duration of diagnosis, education and disease activity of the patients were recorded. Ankylosing spondylitis diagnosis was evaluated according to the Criteria of Ankylosing Spondylitis International Society (ASAS) Classification, 2010. The severity of back pain was assessed with visual analog scale (VAS); disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); functional disability was assessed with the Bath Ankylosing Functional Index (BASFI). In RA diagnosis the American College of Rheumatology (ACR), 2010 criteria were used. The patient’s global function was evaluated with visual analog scale (VAS, 0-10 cm) and disease activity was evaluated with disease activity score (DAS28) in RA patients.
Results: At the mean age of 38.5 ± 9.8 years, 46 male (M) and 14 female (F) patients with AS were included in the study. In patients with AS, BIP score was positively correlated only with peripheral joint involvement (r = 0.32 / p = 0.005). At mean age of 52.1 ± 13 years, 12 male and 43 female patients with RA were included. The BIP score in RA patients did not correlatewith any parameter. The BIP score was not significantly different between the two groups. In the AS group, BIP score was significantly higher in female gender (F = 110.2 ± 29 / M = 95.8 ± 20.5; p = 0.041). There was no gender difference in the RA group according to BIP score. In the whole group only in male gender BIP score was negatively correlated with duration of diagnosis (r = -0.264, p = 0.047); it was positively correlated with BASFI (r = 0.306; p = 0.041). BIP score wasn’t related with BMI in both groups.
Conclusion: In the early active periods of the rheumatologic diseases and
in the later stages of them with the progress of physical disability, BIP may get worse. Also we see high BIP scores in female AS patients. A better understanding of factors affecting BIP will increase the success of treatment regimens. The BIP should be taken into account in the follow up of the chronic rheumatologic diseases like RA and AS.

Key words: Rheumatoid Arthritis; Ankylosing Spondylitis; Body Image Perception.

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