Session Type: Abstract Submissions (ACR)
Background/Purpose: Patients with rheumatoid arthritis (RA) have increased coronary atherosclerosis and this may be related to their increased prevalence of visceral adiposity, insulin resistance, and metabolic syndrome. Epicardial adipose tissue (EAT), a type of visceral fat, may contribute to insulin resistance, and through local paracrine effects, to coronary atherosclerosis. We measured EAT volume in patients with RA (n=162) and a matched control group (n=89) to define the relationship between EAT and markers of cardiometabolic risk in RA.
Methods: Clinical characteristics, inflammatory cytokines, lipids, fasting insulin and glucose, and homocysteine were measured. The homeostatic model of insulin resistance (HOMA) was calculated as a measure of insulin resistance and presence of metabolic syndrome defined by the National Cholesterol Education Program Adult Treatment Panel III criteria. EAT volume and coronary artery calcium score were measured by non-contrast cardiac computed tomography. EAT volume was compared in RA patients and controls, and the relationships between EAT volume and markers of cardiometabolic risk in RA defined.
Results: EAT volume was 108.2 cm3 [77-144.6] (median [IQR]) in patients with RA and 93.9 cm3 [69.9-133.1] in controls (P=0.06). RA patients with metabolic syndrome had significantly higher EAT volume than those without (P<0.001) and each increase in metabolic syndrome criteria count was associated with a 20% increase (95% CI, 14-26%) in EAT volume (p<0.001) independent of age, race and sex. Among RA patients, EAT volume was positively associated with IL-6 (P=0.03), triglycerides (P=0.004), presence of hypertension (P=0.01), HOMA (P<0.001), smoking history (P=0.04), and homocysteine (P=0.001) and negatively associated with HDL (P=0.005) after adjustment for age, race and sex. However, there was no significant association between EAT volume and current use and cumulative dose of corticosteroids (P=0.72 and P=0.90, respectively) or coronary artery calcium score (P=0.24), after adjustment for age, race and sex. With further adjustment for waist circumference as a measure of visceral obesity, EAT was independently positively associated with triglycerides, HOMA, current smoking and homocysteine (all P<0.05).
Conclusion: In patients with RA, EAT volume is associated with metabolic syndrome and independently associated with cardiometabolic risk factors including: insulin resistance, triglycerides, current smoking, and homocysteine levels, but not with coronary artery calcium.
M. J. Ormseth,
G. R. Hartlage,
A. M. Oeser,
C. M. Stein,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/epicardial-adipose-tissue-is-associated-with-cardiometabolic-risk-and-the-metabolic-syndrome-in-patients-with-rheumatoid-arthritis/