Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Role of Body Composition Phenotypes and Adiposity in Disease Activity, Endothelial Dysfunction and Radiological Damage in Rheumatoid Arthritis Patients.
Delgado-Frias1, Esmeralda, Hernandez-Hernandez1, Vanesa, Ferraz-Amaro1, Ivan, Garcia-Dopico2, Jose A., Medina2, Lilian, Gonzalez-Diaz3, Antonieta, Gomez-Rodriguez-Bethencourt3, Maria A.
Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Spain
Servicio de Laboratorio Central, Hospital Universitario de Canarias, La Laguna, Spain
Servicio de Medicina Nuclear, Hospital Universitario de Canarias, Spain
Resonancia Magnética. IMETISA. Hospital Universitario de Canarias
The amount and distribution of fat and lean mass have important implications for health, and systemic inflammation may represent a risk for altered body composition. Rheumatoid arthritis (RA) is associated with changes in body composition and these changes may be factors potentially contributing to affect disease characteristics like endothelial dysfunction or radiological damage.
A total of 85 women, 44 RA patients and 41 age-matched controls were included in this cross-sectional study. Standards anthropometric measures were calculated. Demographic data, the 28-joint DAS (DAS-28) and disability using HAQ scores, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were collected. Quantification of visceral and subcutaneous abdominal fat area was determined using magnetic resonance imaging. Total and regional lean mass and fat mass were measured with dual energy X-ray absorptiometry. Lean mass of arms and legs, total body fat mass, truncal fat distribution, fat-free mass index, and presence or absence of sarcopenia and overfat were established. Radiological progression was defined in RA patients by the Sharp score. Endothelial dysfunction was assessed in patients and controls by brachial artery flow-mediated dilation (FMD) as the dilator response to 5 minutes distal cuff occlusion, and after sublingual nitroglycerine administration.
RA patients showed endothelial dysfunction bias an inferior brachial artery FMD (6.3 vs 10.8 mm, p=0.03). Visceral and subcutaneous abdominal fat areas were not different between RA patients and controls when adjusted for age and body mass index. Abdominal fat through resonance imaging was not associated with endothelial dysfunction, DAS28, ESR, CRP or Sharp score. Only HAQ show a trend to be negatively related with subcutaneous abdominal fat (r2=-0,358, p=0.07). Regard DEXA body composition parameters, overfat states tend to be more frequent in RA patients (chi2=3.26, p=0.07). Disease duration was associated with an inferior fat mass (b coefficient -0.310 kg/years, p=0.03) and with changes in apendicular/truncal phenotypes: higher apendicular fat mass (r2=0.41, p=0.01) and lower truncal fat mass (r2=-0.40, p=0.02). Radiological damage through Sharp score was negatively correlated with fat free index and total lean mass (r2=-0.39, p=0.04) showing that patients with fewer lean mass had higher radiological damage (adjusted for disease duration). This radiological damage was not associated with a specific apendicular or truncal fat mass phenotype. When patients were categorized as sarcopenic or not sarcopenic, radiological damage tends, in addition, to be high in the first group (26.0 vs 10.5 units, p=0.08). FMD was correlated with DAS28 but do not seem to be associated with any body composition phenotype. In our study endothelial dysfunction was not correlated with radiological damage.
Disease activity, radiological damage and disability scores are associated with unhealthy body composition in RA patients. Changes in body composition are partly explained by RA inflammation and these may influence the disease itself.
To cite this abstract, please use the following information:
Delgado-Frias, Esmeralda, Hernandez-Hernandez, Vanesa, Ferraz-Amaro, Ivan, Garcia-Dopico, Jose A., Medina, Lilian, Gonzalez-Diaz, Antonieta, et al; Role of Body Composition Phenotypes and Adiposity in Disease Activity, Endothelial Dysfunction and Radiological Damage in Rheumatoid Arthritis Patients. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2134