Abstract
Rheumatoid arthritis (RA) may influence not only abdominal fat, but also whole body adiposity, since it is associated with chronic inflammation and disability. The study aims to evaluate the whole body adiposity of RA patients and to assess potential influences of disease specific measures. The study was designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. Each subject underwent on the same day clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. A total of 107 RA women and 104 matched controls were included. Compared to controls, the RA group had less physical activity and a higher prevalence of normal weight obesity. Overfat RA women had a significantly higher toll of inflammation, disease activity, glucocorticoid treatment and sedentary behavior. RA women with inflammation, glucocorticoid treatment and higher disease activity class had higher whole body and trunk adipose tissue indices and higher prevalence of overfat status. Glucocorticoid treatment, inflammation, disease duration and severity correlated with whole body adipose tissue and significantly predicted high adiposity content and overfat phenotypes. RA disease duration and severity are associated with higher whole body and regional adiposity. Low-dose glucocorticoid treatment seems to contribute to adiposity gain and redistribution. Clinicians may need to assess body composition and physical activity in RA patients in order to fully manage cardiovascular outcomes and quality of life.
Highlights
Rheumatoid arthritis (RA) is a progressive auto-immune disease characterized by chronic inflammation which leads to joint deformity, disability, distress and socio-economic costs
It seems that body mass index (BMI)-defined obesity has a comparable prevalence among RA and general populations [5], a figure which may be underestimated by the fact that the classical BMI cutoffs are too high for RA patients [6]
Another drawback of BMI is the lack of information regarding the actual amount and distribution of fat, knowing that central obesity and the metabolic syndrome (MetS) are highly prevalent in RA patients [7,8,9]
Summary
Rheumatoid arthritis (RA) is a progressive auto-immune disease characterized by chronic inflammation which leads to joint deformity, disability, distress and socio-economic costs. The RA-adipose tissue interaction entails central adiposity, the metabolic syndrome (MetS) and obesity classically defined by a body mass index (BMI) above 30 kg/m2 It seems that BMI-defined obesity has a comparable prevalence among RA and general populations [5], a figure which may be underestimated by the fact that the classical BMI cutoffs are too high for RA patients (for a given body fat content, RA patients had a BMI with 2 kg/m2 lower than controls, probably due to the loss of muscle mass and to the gain of fat mass) [6]. Most of the studies included both genders, despite the facts that RA is more prevalent among women and that body composition differs significantly between genders In this context,we hypothesized that there must be a specific effect of RA measures on whole body adiposity, not exclusively on abdominal fat, since the disease is associated with a number of factors which can influence the adipose tissue (e.g. inflammation, disability, glucocorticoids). The study aims to evaluate the whole body adiposity RA patients using DXA and to assess potential influences of disease measures on body composition phenotypes
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