P040 Obesity and rheumatoid arthritis among individuals with low education

Abstract Background/Aims Poor education is connected to many diseases including cardiovascular diseases (CVD) and some CVD-related risk factors such as obesity. However, precisely how this relationship occurs is unknown. In this research we will be exploring how the connection between obesity and overall mortality is modified by rheumatoid arthritis (RA). Methods Our study was conducted on participants that were aged 20 years or older living in the United States with a education level of only some high school. We assessed RA status by using the arthritis question in the National Health and Nutrition Examination Survey (NHANES) survey conducted by the National Center for Health Statistics (NCHS) for the years of 1999 to 2010 with mortality follow-up to December 2019. We determined obesity by calculating BMI and setting a cutpoint at 30 kg/m2. Education level was determined through self-reported data. Chronic Kidney Disease was determined using the Cockcroft-Gault equation. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of obesity and mortality, and if RA has an overall relationship in those with low education. Results Among individuals with low education and RA, percent mortality was 32.3% among males and 32.6% among females with mean follow-up of 9.3 years. For overall mortality, the age and sex-adjusted hazard ratio (HR) for obesity was 1.18 (95% confidence interval [CI], 1.05-1.34 p = 0.01). The adjusted HR was elevated, 1.56 (CI 1.06-2.32, p = 0.03), among people with obesity who also had RA but close to 1.0 (1.21 CI 0.99-1.47, p = 0.06) among individuals with obesity who had no RA, after adjusting for medical (chronic obstructive pulmonary disease, history of cancer, cardiovascular disease, chronic kidney disease, and diabetes) and demographic risk factors (poverty-income-ratio, age, military service, citizenship, and gender). Conclusion We found that among individuals with low education, not only does obesity lead to 18% higher overall mortality but also RA occurrence impacts the relationship between obesity and overall mortality even after controlling for potential confounders. Education and health literacy are especially important in the preventing and treating RA especially in those who have obesity. With cardiovascular disease having the highest rate of mortality, risk factors for CVD such as obesity must be prevented. Disclosure J. Khubchandani: None. S. Banerjee: None.