Background/Purpose: To determine the relationship between measures of body composition (total body composition derived from dual energy X-ray absorptiometry and abdominal adiposity through magnetic resonance imaging) with comorbidities in rheumatoid arthritis (RA) like disease activity, radiological damage and endothelial dysfunction. Methods: 216 subjects, 111 RA patients and 105 age and sex-matched healthy controls were included in this case-control study. Anthropometric and demographic characteristics, cardiovascular risk measurement through SCORE index, C-reactive protein (CRP), Disease Activity Score (DAS28), Health Assessment Questionnaire (HAQ), and radiological damage through Sharp index were determined. Quantification of visceral and parietal abdominal fat area was assessed using magnetic resonance imaging. Total body composition, total and regional lean mass, and fat mass and fat free mass indexes were measured by dual energy X-ray absorptiometry (DEXA). The presence of sarcopenia or overfat phenotype was established. Endothelial dysfunction was assessed through brachial artery flow-mediated dilatation sonography. Multivariate analysis was performed to define the relation of this body composition with disease characteristics. Results: 1) Body composition. Percentage of lean and fat mass did not differ between patients and controls. Appendicular to total lean mass (0.42 ± 0.02 vs. 0.40 ± 0.03, p=0.00) and appendicular to trunk lean mass (0.82 ± 0.08 vs. 0.78 ± 0.08, p=0.00) were significantly lower in RA patients. Parietal abdominal tissue was lower in male RA patients (19089 ± 1234 vs. 1345 ± 3930 cm², p=0.02), this difference were not reached in female patients. Presence of sarcopenia tended to be higher in RA patients (13 versus 7%, p=0.17) when compared to controls. Although differences in overfat were not reached between controls and patients, 44% of RA patients had a body mass index higher than 30 kg/m² (32% in controls, p=0.09) and 96% of RA patients were considered to be overfat through DEXA criteria (96% in controls).  2) Radiological damage. Patients with a lean mass index lower that the hypothetical percentile 25 expressed higher Sharp index when compared to patients in percentile 75 or superior (22±28 vs. 9.4±9, p=0.02) and after adjusting for disease activity. Overfat phenotypes did not show associations with radiological damage.  3) Disease activity. Sarcopenic patients had higher CRP (3.8 [1.8-29.7] vs 2.8 [1.3-7.2] mmg/dL, p= 0.04) and a trend to higher HAQ score (1.2 [0.38-1.75]  vs 0.75 [0.30-1.38], p=0.18).  4) Endothelial dysfunction. Patients with 2 standard deviation of lean mass below normality expressed lower flow-mediated when compared to controls (1.9 [0-8] vs 5.4 [0-9], p=0.14). Conclusion: Overfat and sarcopenia are present in RA patients and are related to several disease characteristics.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/abdominal-adiposity-and-body-composition-in-rheumatoid-arthritis-relation-with-disease-characteristics-in-a-case-control-study/