Abstract
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are associated with changes in body composition. Ectopic intramuscular fat (IMAT) may alter muscle function and contribute to cardiometabolic disorders. In a pilot study, we analyzed IMAT in the calf with peripheral quantitative computed tomography (pQCT) and examined correlations between IMAT quantity and body composition parameters. In 20 patients with active RA and 23 with active SpA, IMAT was correlated with visceral fat (VAT; r = 0.5143 and 0.6314, respectively; p < 0.05) and total lean mass (r = 0.5414 and 0.8132, respectively; p < 0.05), but not with whole body fat mass. Total lean mass mediated 16% and 33% of the effects of VAT on IMAT in RA and SpA, respectively. In both RA and SpA, calf muscle area was correlated with total lean mass (r = 0.5940 and r = 0.8597, respectively; p < 0.05) and fat area was correlated with total body fat (r = 0.6767 and 0.5089, respectively; p < 0.05) and subcutaneous fat (r = 0.6526 and 0.5524, respectively; p < 0.05). Fat area was inversely correlated with handgrip and walking tests, and it was associated with disease activity and disability. We showed that ectopic IMAT, measured with pQCT, was correlated with VAT, but not with total body fat, in RA and SpA. This result suggests that metabolically active fat was specifically associated with IMAT.
Highlights
Licensee MDPI, Basel, Switzerland.Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are associated with increased cardiovascular risk [1]
We found that the visceral fat (VAT) and the total lean mass values were significantly associated with the intramuscular fat (IMAT)
We found that muscle area was correlated with handgrip strength and less severe disease (RAID), and that fat area was associated with disease activity (DAS28) and inversely correlated with the
Summary
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are associated with increased cardiovascular risk [1]. These associations are partly due to classic cardiovascular risk factors, but they are due to the presence of systemic inflammation which leads to metabolic disorders, such as insulin resistance and altered body composition. Studies have shown that sarcopenia was 2- to 3-fold more frequent in patients with RA than in healthy controls [2–5], and sarcopenia was associated with ectopic fat deposits [6]. Cachexia-associated metabolic disorder might explain the finding that a low body mass index (BMI) was associated with an increase in cardiovascular mortality by 2- to
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