Session Information
Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment: Cardiovascular Disease and Pregnancy
Session Type: Abstract Submissions (ACR)
Background/Purpose
Women with systemic lupus erythematosus (SLE) have an increased risk of cardiovascular disease (CVD). We have shown that clinically CVD-free women with SLE have an increased volume of descending aortic perivascular adipose tissue, which is also associated with aortic calcification independent of overall adiposity. The relative volumes of brown (BAT) versus white adipose tissue (WAT) may also influence the development of exacerbated CVD. Typically, increased BAT has been associated with a leaner and healthier phenotype, while increased WAT has been associated with an obese-like state. We hypothesized that greater pericardial adipose tissue (PAT) and WAT volumes will be associated with coronary artery calcification (CAC) in clinically CVD-free women with SLE.
Methods
Women participating in the “Heart Effects on Atherosclerosis and Risk of Thrombosis in SLE” (HEARTS) study were clinically CVD-free and diagnosed with SLE for at least 2 years. CAC was measured using electron beam computed tomography (EBCT) and quantified by Agaston scoring. The PAT (epicardial + paracardial adipose tissue) was quantified using commercially available software and attenuation values for overall adipose volume (–190 to –30 HU), WAT (-190 to -75HU), and BAT (-75 to -30 HU). Logistic regression modeling for any CAC was used to evaluate associations. Models were adjusted for CVD risk factors (age, waist-to-hip ratio, menopausal status and hypertension) and circulating inflammatory markers (C3, C4 and CRP).
Results
The study included 156 SLE women and 46% (72/156) had any CAC. SLE women with CAC had higher circulating levels of C3 (p=0.0002), C4 (p=0.001), and CRP (p=0.0001). The WAT to BAT ratio (rSpearman=0.35, p=0.006) was significantly correlated with the extent of CAC. In unadjusted logistic regression models PAT (Odds Ratio/OR[95% CI], p-value: 1.02[1.01-1.03], <0.0001), WAT (1.03[1.01-1.04],<0.0001), and BAT (1.05[1.03-1.08],<0.0001) were significantly associated with any CAC. The three volumetric adipose measures maintained significance after adjusting for CVD risk factors (PAT (p=0.006), WAT (p=0.02), and BAT (p=0.002)) and circulating inflammatory markers (PAT (p=0.002), WAT (p=0.007), and BAT (p=0.0005).
Conclusion
Approximately half of the clinically CVD-free SLE women in this study had CAC. Traditional CVD risk factors do not explain the exacerbated CVD risk in the SLE population. We found that PAT and the relative WAT and BAT volumes were independently associated with any CAC even after adjustment for CVD risk factors and circulating inflammatory markers. Small visceral adipose depots surrounding the heart and vasculature may provide localized inflammation promoting CVD.
Disclosure:
K. J. Shields,
None;
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-coronary-artery-calcification-with-brown-and-white-pericardial-adipose-tissue-in-sle/