Session Type: ARHP Concurrent Abstract Session
Session Time: 2:30PM-4:00PM
Background: Obesity has been traditionally considered to protect the skeleton against osteoporosis and fracture. Recently, body fat, specifically visceral adipose tissue (VAT), has been associated with lower bone mineral density (BMD) and increased risk for some types of fractures. Chinese visceral adiposity index (CVAI) is a validated index for the evaluation of visceral fat dysfunction in Asians and strongly correlated with insulin resistance (IR) and was found to predict metabolic syndrome (MS), hypertension and diabetes better than body mass index (BMI) and waist circumference (WC). Spinal cortical and trabecular bone mineral density (BMD) were found to be inversely correlated with visceral adipose area measured by computed tomography even after adjusting for BMI. Whether CVAI correlates with bone microstructure in early rheumatoid arthritis (ERA) has not been assessed.
Purpose: 1) To compare CVAI between ERA patients and controls; 2) To assess the relationship between CVAI and the bone microstructure detected by high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with ERA.
Methods: In this study, 104 female ERA patients treated with a tight-control protocol using csDMARDs were prospectively followed for 1 year. 30 female healthy controls were also recruited. All the 104 female ERA patients were scanned by HR-pQCT of the distal radius and tibia at baseline and one-year. CVAI was calculated by the following formula: CVAI = -187.32+1.71× age + 4.23 × BMI +1.12 × WC (cm) + 39.76 × Log10 TG -11.66 × HDL-C. The female ERA patients were sub-grouped according to the median CVAI value (65.73) (low CVAI and high CVAI groups).
Results: After adjusting for age and BMI, the CVAI in the ERA group was significantly higher than the control group (55.10 ± 32.02 versus 41.11 ± 20.89, p=0.010). ESR level at baseline in the high CVAI group was statistically higher than the low CVAI group (73.63 ± 34.49 versus 55.52 ±27.52, p=0.038). Cortical volumetric BMD (vBMD) in the distal radius and tibia at baseline were significantly lower in the high CVAI group compared to the low CVAI group (all p<0.01). Linear regression models indicated that CVAI at baseline was an independent negative predictor of distal radius cortical vBMD at Month 12 (B=-1.033, p=0.022, 95%CI: -1.914~-0.153) and tibia cortical vBMD at Month 12 (B=-0.828, p=0.003, 95%CI: -1.366~-0.290). In addition, CVAI at baseline was an independent predictor of the decreased trabecular vBMD in tibia (B=0.040, p=0.001, 95%CI: 0.018~0.063) and decreased trabecular vBMD in distal radius (B=0.233, p=0.008, 95%CI: 0.063~0.403).
Conclusion: CVAI is an independent predictor of bone loss in female patients with ERA. CVAI may have an important role in the changed trabecular density. These associations may be mediated by a chronic inflammatory state.
To cite this abstract in AMA style:Yue J, Wong P, Griffith JF, XU J, XIAO F, Wu D, Li E, Tam LHP, Li M, Li TK, Zhu TY, Hung VW, Qin L, Tam LS. A Close Relationship between a Novel Visceral Adiposity Index and Bone Microstructure in Female Early Rheumatoid Arthritis Patients: A 1-Year Follow-up Study By HR-pQCT [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/a-close-relationship-between-a-novel-visceral-adiposity-index-and-bone-microstructure-in-female-early-rheumatoid-arthritis-patients-a-1-year-follow-up-study-by-hr-pqct/. Accessed October 23, 2020.
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