Date: Monday, November 9, 2015
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Studies have shown a strong prevalence of cardiovascular events among patients with spondyloarthritis (SpA). Recent studies indicate that visceral adipose tissue (VAT) is highly associated with insulin resistance and cardiovascular events. Dual energy X-ray absorptiometry (DXA) is a validated technique able to accurately determine cross-sectionally the mass of discret fat deposits.
The objectives of our study were to assess the 2-year changes in abdominal fat mass in patients with early inflammatory back pain suggestive of SpA, in the DESIR cohort and to identify the variables significantly associated with these changes.
Among the 708 patients of the DESIR cohort (inflammatory back pain of less than 3 years duration suggestive of axial SpA), 265 had BMD measurements at baseline and after 2 years of follow-up, and 129 had body composition and abdominal adiposity measurements. Alongside the evaluation of clinical and paraclinical features associated with early SpA and increased cardiovascular risk, DXA was performed to evaluate body composition and abdominal adipose tissue (subcutaneous adipose tissue (SAT) and VAT). We assessed changes in abdominal fat mass (VAT, SAT) over 2 years. Then, we assessed the variables associated with abdominal fat mass changes using linear regressions. Afterwards, we compared the abdominal fat mass changes in patients treated with TNF-blockers or free of TNF-blockers. Finally, we tested the role of inflammation (defined by a CRP >6mg/L or presence of MRI inflammatory signals at the spine or sacro-iliac joint level) in the 2-year abdominal fat mass changes.
A total of 129 patients of the DESIR cohort (71 men (55.0%), mean age of 33.0 (±8.6) years old) with a mean disease duration of 17.9 (±10.7) months, were included. Their mean body mass index was 23.7 (±3.5) kg/m2 and the prevalence of obesity (BMI>30 kg/m²) was 6.2%. We did not find any significant changes of SAT over 2 years; VAT tended to increase over 2 years from baseline of 7.3% (±28%) (p= 0.054). 2-year VAT changes was significantly associated with the presence of the baseline ASAS criteria fulfillment (p=0.015), hypercholesterolemia at baseline (p=0.007), hypertriglyceridemia at baseline (p=0.0026) and 2-year changes in BMI (p<0.01).
Thirty nine (30.2%) patients received anti-TNF treatment during the 2 years follow-up period. The SAT changes were not significantly different between patients with and without anti-TNF (+2.9%, p=0.323). However, VAT tended to increase from baseline in the anti-TNF group (+5.2%, p=0.053).
Presence or absence of inflammation had no significant impact on 2-year abdominal fat mass changes (p=0.358 for VAT and p=0.508 for SAT).
To our knowledge, this study is the first one assessing the abdominal adiposity changes in early inflammatory back pain suggestive of SpA. VAT tended to increase over a 2 years follow-up period, especially in patients receiving anti-TNF. Further studies with larger samples are necessary to confirm or not these results and to evaluate their clinical relevance.
To cite this abstract in AMA style:Che H, Etcheto A, Souffir C, Kolta S, Richette P, Molto A, Dougados M, Roux C, Briot K. Abdominal Fat Mass Assessment in Recent Onset Spondyloarthritis: Data from the DESIR Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/abdominal-fat-mass-assessment-in-recent-onset-spondyloarthritis-data-from-the-desir-cohort/. Accessed December 16, 2017.
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ACR Meeting Abstracts - http://acrabstracts.org/abstract/abdominal-fat-mass-assessment-in-recent-onset-spondyloarthritis-data-from-the-desir-cohort/