Background/Purpose:  Young woman with lupus (SLE) are at increased risk of early atherosclerosis leading to cardiovascular disease in adult life and consequently higher morbidity and mortality. Recently, it has been demonstrated that visceral adipose tissue (VAT) is associated with increased incidence of metabolic risk in subclinical atherosclerosis beyond its contribution to overall adiposity. Nowadays, a new application of dual-energy X-ray absorptiometry (DXA) is to measure VAT in the android region of a whole body site with high accuracy and strong correlation with computed tomography (CT) to quantify visceral fat. Thus, the objective of this study was assess alterations of visceral adipose tissue (VAT) measured by DXA in juvenile female SLE (JoSLE) patients compared with age-matched healthy controls and evaluate its correlation with disease parameters and treatment.

Methods: Fifty-six JoSLE female patients were evaluated and compared with age-matched female healthy controls. Demographic and anthropometric, disease duration, disease activity score (SLEDAI), cumulative organ damage (SLICC-DI/ACR), glucocorticoid (GC) use and hydroxychloroquine use were recorded by interview and eletronic chart review. Visceral adipose tissue (VAT) was analyzed by dual-energy X-ray absortiometry (DXA, Hologic – using a specific software – APEX 4.0).

Results: SLE patients had mean disease duration of 5.71 ± 3.98 years, mean current prednisone dose of 15.99 ± 18.62 mg/day and cumulative glucocorticoid dose of 6.79 ± 7.13 g, mean SLEDAI of 4.60 ± 5.54 in the last year and eleven (19.6%) patients had SLICC-DI/ACR higher than one. SLE patients and controls were similar regarding age (18.4 ± 3.2 vs. 18.6 ± 3.8 yrs, p=0.808), weight (57.4 ± 10.8 vs. 56.8 ± 9.3 kg, p=0.752), BMI (23.1 ± 3.6 vs. 22.3 ± 3.2 kg/m², p=0.205) and lean mass (36.19 ± 6.60 vs. 36.81 ± 4.24 kg, p=0.420). JoSLE patients presented higher levels of fat mass compared to healthy controls (19.26 ± 6.60 vs. 17.86 ± 6.22 kg, p=0.017), as well as % fat (32.93 ± 6.35 vs. 30.82 ± 5.72 %, p=0.004). Furthermore, SLE patients had higher values of VAT parameters than controls, namely VAT mass (280.55 ± 132.42 vs. 199.60 ± 98.67 g, p<0.001), VAT area (58.19 ± 27.47 vs. 41.41 ± 20.50 cm², p<0.001) and VAT volume (303.36 ± 143.19 vs. 215.78 ± 106.66 cm³, p<0.001). In SLE patients, VAT volume correlated with disease duration (r=0.313; p=0.019) and SLICC-DI/ACR (r=0.300; p=0.025) but not with SLEDAI (p=0.907), current use of GC (p=0.449), cumulative use of GC (p=0.346) or hydroxychloroquine use (p=0.385).

Conclusion: JoSLE patients showed higher levels of VAT parameters compared to healthy controls. Its correlation with higher cumulative organ damage index and disease duration could suggest that VAT can be useful to evaluate cardiovascular risk in this group of patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/visceral-adiposity-assessed-by-dxa-in-juvenile-onset-systemic-lupus-erythematosus-a-correlation-with-damage-index-and-disease-duration/