Background/Purpose:  Granulomatosis with polyangiitis (GPA, Wegener´s) patients are more exposed to traditional cardiovascular risk factor, including obesity. In rheumatic diseases, inflammation has been associated with abnormal body composition (BC). Visceral adipose tissue (VAT) is a metabolically active tissue and is a source of humoral and cellular inflammation. It has been demonstrated that VAT is associated with incidence metabolic risk beyond its contribution to overall adiposity. Therefore, the objective of this study is to compare BC parameters, with emphasis in body fat and VAT, in GPA patients versus healthy controls and to explore the association of these parameters with disease activity and inflammatory markers.

Methods:  This cross-sectional study was conducted in 32 GPA patients and 32 healthy controls matched by sex, age and body mass index (BMI). Disease activity was assessed by Birmingham Vasculitis Activity Score (BVAS) and ANCA. Damage was assessed by Vasculitis Damage Index (VDI). C-reactive protein (CRP, normal: < 5mg/L) and Erythrocyte sedimentation rate (ESR, normal < 15mm/1^st hour for men and < 20mm/1^st hour for women) were measured. BC was analyzed using dual-energy X-ray absorptiometry (DXA). Fat mass parameters evaluated were: total fat mass (FM), adiposity (percentage of body fat), fat mass index (FMI: fat mass/ht²) and VAT (g, cm³, cm²).

Results:  Compared GPA patients with healthy controls, a significantly greater VAT (696.00 ± 284.96 vs. 574.34 ± 243.82 g, p=0.03; 752.34 ± 313.01 vs. 621 ± 263.60 cm³, p=0.03 and 144.34 ± 60.02 vs. 119.11 ± 50.54 cm², p=0.03) were observed in patients. GPA patients with BVAS > 1 demonstrated higher adiposity (38.71 ± 12.16 vs. 31.47 ± 9.29%, p=0.04) and FMI (13.78 ± 6.43 vs. 9.66 ± 4.39 Kg/m², p=0.02), compared to patients with BVAS ≤ 1. ANCA and VDI were not associated with any fat mass parameters. Elevated CRP and ESR were observed in GPA patients with higher FMI (13.54 ± 6.45 vs. 9.72 ± 4.45 Kg/m² p=0.04 and 13.68 ± 6.81 vs. 9.68 ± 4.27 Kg/m² p=0.03, respectively). No correlation was observed between fat mass parameters (FM, adiposity, FMI and VAT) and prednisone cumulative dose (p>0.05).

Conclusion:  Our data suggest that GPA patients have abnormal BC, mainly in fat mass parameters and these variables are associated with inflammation and disease activity suggesting that BC should be evaluated in GPA patients to understand and prevent comorbidities in these subjects.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-body-composition-parameters-in-granulomatosis-with-polyangiitis-association-of-fat-mass-parameters-with-disease-activity-and-inflammatory-markers/