Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Effects of Body Fat Distribution On Insulin Resistance and Coronary Atherosclerosis in Rheumatoid Arthritis
Brey1, David, Rho1, Young-Hee, Oeser1, Annette M., Solus1, Joseph, Raggi2, Paolo, Gebretsadik1, Tebeb, Shintani1, Ayumi
Rheumatoid arthritis (RA) is associated with insulin resistance and increased coronary atherosclerosis. In the general population, it is known that body mass index (BMI) is associated with insulin resistance and cardiovascular risk, whereas waist circumference (WC) and waist-to-hip-ratio (WHR), measures of abdominal adiposity, better predict adverse metabolic and cardiovascular outcomes. We examined the hypothesis that in patients with RA, anthropometric measures that encompass abdominal adiposity are more strongly associated with insulin resistance and coronary atherosclerosis than BMI.
We studied 169 patients with RA who are part of an ongoing cohort to define the relationship between RA and cardiovascular disease. Height, weight, hip circumference, and WC were measured, and BMI and WHR were calculated. Insulin sensitivity was measured by the homeostasis model assessment (HOMA). Patients underwent chest computed tomography, and Agatston coronary artery calcium scores (CAC) were calculated. Gender specific effects of anthropometric measures on HOMA and CAC were assessed using multivariable regression adjusting for age and race.
There were 52 men (age 54.6±11.2 yrs, BMI 28.1±6.82 kg/m2, WC 101.1±17.2 cm, WHR 0.94±0.07) and 117 women (age 54.1±12.1 yrs, BMI 29.6±6.7 kg/m2, WC 93.1±16.8 cm, WHR 0.85±0.09). In women, BMI (p = 0.02) and WC (p = 0.004) were associated with HOMA; WHR (p =0.04) alone was associated with CAC. In men, there was no significant association between BMI, WC, and WHR and the outcomes of HOMA and CAC (Figure).
The Figure shows adjusted means ratio for HOMA, or the odds ratio for Agatston scores for a change of one interquartile range of BMI, Waist, and WHR with 95% CI for men ([loz]) and women ([cir]).
In women with RA, WHR is significantly associated with coronary calcification, and BMI and WC with insulin resistance. Anthropometric measures of obesity may provide information additional to that provided by BMI about the metabolic and cardiovascular consequences of obesity in RA.
To cite this abstract, please use the following information:
Brey, David, Rho, Young-Hee, Oeser, Annette M., Solus, Joseph, Raggi, Paolo, Gebretsadik, Tebeb, et al; Effects of Body Fat Distribution On Insulin Resistance and Coronary Atherosclerosis in Rheumatoid Arthritis [abstract]. Arthritis Rheum 2009;60 Suppl 10 :952