Lung Function Status and Associated Factors Among Rheumatoid Arthritis Patients, Southwest Ethiopia: A Comparative Cross-Sectional Study

Abstract

Tefera Darge, Samuel Tadesse, Hiwot Birhanu, Bashatu Barkessa, Zewudu Befikadu, Sisay Teferi, Yared Nigusu and Alemayehu Babusha

Background: Rheumatoid arthritis (RA) is a chronic progressive autoimmune multi-systemic inflammatory disease. Pulmonary involvement and complications remain an important cause of morbidity and mortality among RA patients. Spirometry is a simple, less expensive, and first-line tool in the screening of pulmonary function disorders.

Objective: The study aimed to assess the lung function status and associated factors among RA patients, Southwest Ethiopia, 2023.

Methods: An institution-based comparative cross-sectional study was conducted among 248 participants at JMC and MKH in Southwest Ethiopia ,2023. A face-to-face interview, utilizing a semi-structured questionnaire, was employed, and the DAS28-ESR was assessed for each RA participant. spirometry parameters, including FVC (L), FEV1 (L), FEF 25-75% of the FVC (L/s), and PEFR (L/s), were measured using a digital spirometer (SP10) and interpreted according to American Thoracic Society guidelines. Collected data were analyzed using SPSS version 26. Finally, descriptive statistics, independent t-tests, and binary and multiple logistic regression analyses were performed, with statistical significance set at a 5% level.

Results: The present study indicated that the means of the spirometry parameters among RA patients were significantly lower when compared to their age, sex, area of residence ,and weight-matched healthy adult study participants (FVC(L) (m = 3.00 ± 0.38) vs. (m=3.60 ± 0.35), (FEV1(L) ((m = 2.31± 0.34) vs. (m=2.81 ± 0.38, (PEFR(L/s) (m = 5.77 ± 0.84) vs. (m=6.63 ± 0.81, and (FEF25-75 % (L/s) patients (m = 2.41 ± 0.37) vs. (m=2.82 ± 0.34). Generally, 53 (42.8%) and 7 (5.7%) of the RA and healthy adult respondents had at least one pulmonary function abnormality, respectively. Physical inactivity [AOR=5.5, 95% CI=1.4-21.8], biomass exposure [AOR=4.4, 95% CI=1.3-14.8], Moderate-high disease activity [AOR=4.2, 95% CI=1.71-12.4], and WC > 80 cm and > 90 cm for males and females, respectively [AOR=3.6, 95% CI=1.06-11.94] were all independent predictors of pulmonary function abnormality in RA patients.

Conclusions: Compared to the healthy adults, patients with RA exhibited significantly lower spirometry results, indicating a higher prevalence of pulmonary function abnormalities. Physical inactivity, exposure to biomass, moderate- high disease activity, and increased waist circumference, specifically greater than 80 cm for females and 90 cm for males were independent predictors of impaired pulmonary function in RA patients.

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