Increased visceral adipose tissue and altered adiposity distribution in premenopausal lupus patients: correlation with cardiovascular risk factors

Abstract

Objective Visceral adipose tissue (VAT) correlates with cardiovascular risk factors and has never been assessed in systemic lupus erythematosus (SLE). Our aim was to evaluate VAT in premenopausal SLE patients. Methods Sixty-three premenopausal SLE patients and 186 age-matched healthy women were included. Demographic, anthropometric, disease and treatment parameters were evaluated. VAT was measured by dual X-ray absorptiometry (DXA) with APEX 4.0 software. Results SLE patients had a disease duration of 5.25 ± 3.80 years, SLEDAI activity score of 4.35 ± 5.13, SLICC/ACR-DI of 0.70 ± 0.80, current prednisone dose of 11.60 ± 12.10 mg/day and cumulative glucocorticoid dose of 22.34 ± 12.94 g. Overweight/obese SLE patients and controls had similar VAT parameters ( p > 0.05). Among individuals with BMI <25 kg/m, SLE patients and controls had similar weight, fat mass and fat percentage ( p > 0.05) but patients had higher values of VAT parameters (VAT mass: 260.60 ± 117.23 vs. 194.77 ± 71.42 g, p = 0.001; VAT area: 54.05 ± 24.30 vs. 40.40 ± 14.82 cm, p = 0.001; VAT volume: 281.75 ± 126.81 vs. 210.61 ± 77.29 cm, p = 0.001) and trunk/limb fat mass ratio (0.78 ± 0.21 vs. 0.67 ± 0.12, p = 0.002) compared to controls. In SLE, VAT area correlated with weight ( r = 0.66, p < 0.001), non-HDL cholesterol ( r = 0.53, p < 0.001), LDL cholesterol ( r = 0.48, p < 0.001) and triglycerides ( r = 0.33, p = 0.008), but not with disease duration, SLEDAI, SLICC/ACR-DI or current glucocorticoid use ( p > 0.05). Conclusion This study provides original evidence that SLE is associated with increased VAT and altered adiposity distribution. The correlation with traditional risk factors for cardiovascular disease, independent of current glucocorticoid dose and disease activity, suggests the role of visceral fat as an additional tool for risk assessment in these young patients.

Altered body composition and increased visceral adipose tissue in premenopausal and late postmenopausal patients with SLE

“…In addition, LPC Seguro et al [9] failed to find that VAT was related to disease duration, SLEDAI score, SLICC/ACR-DI, or current glucocorticoid use. In the present study, we identified several SLE disease-related factors positively associated with increased VAT: SLE disease duration and SLICC/ ACR-DI score, whereas low complement C3/C4 was negatively associated.…”

“…They concluded that the volume of PVAT was greater in female SLE patients than in age-and race-matched controls and associated with calcification in different vascular beds, which could influence CVD. LPC Seguro et al [9] used DXA to evaluate VAT in premenopausal patients with SLE, and they found that SLE was associated with increased VAT, and the latter was correlated with traditional CV risks. Our result was partly consistent with their result that premenopausal SLE patients with BMI less than 25 had a higher VAT parameter than controls.…”

“…Traditional CV risk factors, such as age, hypertension, dyslipidemia, and smoking, cannot fully explain the increased CVD occurrence in SLE [5][6][7], and disease-related risk factors, such as disease activity, cumulative damage, renal involvement, inflammatory mediators, and medications, have been implicated in increasing the CV risk in SLE [8]. Recently, Seguro et al showed that SLE was associated with altered adiposity distribution and increased visceral adipose tissues (VAT) in premenopausal SLE patients, and that VAT was correlated with traditional risk factors for CVD [9].…”

“…Unfortunately, there were only two studies examining VAT and its determinants among patients with SLE [9,13], and the changes of VAT in postmenopausal patients with SLE and in Chinese patients have never been reported. Since the prevalence and disease activity of SLE were found to have geographical variations, SLE patients in Asia may be different from those on other continents.…”

Bioimpedance analysis in determining body composition in women with systemic lupus erythematosus: a pilot study

“…Seguro и соавт. [14] сравнили СТ у женщин с СКВ молодого возраста (31 год) и сопоставимых по возрасту, массе тела и ИМТ здоровых доно-С О В P E М Е Н Н А Я Р Е В М А Т О Л О Г И Я № 1 ' 2 0 О Р И Г И Н А Л Ь Н Ы Е И С С Л Е Д О В А Н И Я / O R I G I N A L I N V E S T I G A T I O N S ров. Пациентки не отличались по количеству общего жира, но имели больше висцерального жира (по массе, объему и площади; p=0,001).…”