Session Information
Date: Sunday, November 8, 2015
Title: Vasculitis Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Studies have shown a strong prevalence of cardiovascular events among patients with systemic necrotizing vasculitides (SNV). Recent studies indicate that visceral adipose tissue (VAT) is highly associated with cardiovascular events. The aim of this study was to assess the relevance of abdominal adipose tissue measurement by Dual energy X-ray Absorptiometry (DXA) as a potential surrogate marker for cardiovascular risk in patients with SNV.
Methods: Patients with SNV seen in our department were prospectively included in a cross-sectional study assessing cardio-vascular complications and risk factors, and other sequelae. DXA was performed to evaluate body composition and abdominal adipose tissue (both subcutaneous (SAT) and visceral (VAT)).
Results: One hundred and twenty consecutive patients with SNV were analyzed (66 female and 54 male, mean age 53±18 years, median disease duration of 54 months). Diagnoses were granulomatosis with polyangiitis in 61 patients, eosinophilic granulomatosis with polyangiitis in 30, polyarteritis nodosa in 14, microscopic polyangiitis in 13, and cryoglobulinemia vasculitis in 2. The median daily dose of glucocorticoids was 8.5 mg/day (0-80), with an estimated total cumulative dose of 15000±10000 mg of glucocorticoids.
High cardiovascular risk, as defined by the NCEP-ATPIII, was present in 28 (23.3%) patients, including 15 (12.5%) with previous cardiovascular disease. Variables significantly associated with high cardiovascular risk after multivariate analysis were an increased age [OR 1.04 (1.00-1.08); P=0.048] and an increased VAT/SAT ratio [OR 1.06 (1.03-1.09); P<0.0001]. The VAT/SAT ratio was significantly higher in patients with high cardiovascular risk (66.3±21.2 vs. 39.4±18.2%, P<0.0001), particularly those with previous cardiovascular history (75.2±13.4 vs. 41.1±19.5%, P<0.0001). A higher VAT/SAT ratio was independently associated with increased age (P<0.0001), male gender (P<0.0001), and elevated levels of triglycerides (P=0.01), glycated hemoglobin (P=0.007) and troponin (P=0.05).
The Framingham cardiovascular risk score, predicting a subject’s risk of developing an ischemic cardiac disease in the next 10 years, was strongly correlated with the VAT/SAT ratio in our patients (r=+0.60, P<0.0001), but also with the 10-year probability of major osteoporotic (r=+0.35, P=0.0009) and hip (r=+0.51, P<0.0001) fractures using the FRAX.
Conclusion: This is the first study showing a significant association between a high VAT/SAT ratio assessed by DXA and cardiovascular risk in patients with SNV. The measurement of the abdominal adipose tissue seems to be an accurate and independent surrogate marker of cardiovascular risk in these patients. Finally, cardiovascular and osteoporotic fracture risks were strongly associated suggesting that optimal management of both risks is crucial in these patients.
To cite this abstract in AMA style:
Dunogué B, Briot K, Kolta S, Regent A, Cohen P, Berezne A, Puéchal X, Le Jeunne C, Mouthon L, Roux C, Guillevin L, Terrier B. Abdominal Visceral Adipose Tissue Measured By Dual Energy X-Ray Absorptiometry (DXA) As a Novel Surrogate Marker of Cardiovascular Risk in Primary Necrotizing Vasculitides [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/abdominal-visceral-adipose-tissue-measured-by-dual-energy-x-ray-absorptiometry-dxa-as-a-novel-surrogate-marker-of-cardiovascular-risk-in-primary-necrotizing-vasculitides/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/abdominal-visceral-adipose-tissue-measured-by-dual-energy-x-ray-absorptiometry-dxa-as-a-novel-surrogate-marker-of-cardiovascular-risk-in-primary-necrotizing-vasculitides/