Abstract

Background:Raynaud’s phenomenon (RP) is a diffuse clinical manifestation (3-5% of general population) RP is often secondary to autoimmune systemic diseases, while the condition is classified primary if no underlying disorders can be found. A lower body mass index (BMI) was associated with a greater risk of developing RP, perhaps due to greatest sensivity to cold temperaturesObjectives:The objective of our study was to evaluate the association of BMI with clinical and capillaroscopic features in primary and secondary RP.Methods:Consecutive patients at the first access to a Rheumatology Outpatient Clinic over a 13 months period were screened to RP; nailfold videocapillaroscopy (NVC)was carried out and qualitative and quantitative assessment was performed. Diagnosis of RP was defined in patients who identified color pictures of witnessed attacks.Patients enrolled were screened for secondary causes of RP. RP was classified as primary when no abnormalities were found. Weight and height were collected in clinical records and patients were divided in 3 groups according to their BMI: underweight (BMI<18.5 kg/m2), normal weight (BMI 18.5–25 kg/m2), and overweight (BMI >25 kg/m2). Chi-square test to compare categorical variable and Parametric Student t-test to comparing mean values of normally distributed data were used. p<0.05 was considered to be statistically significant.Results:RP was diagnosticated in 100 of 1416 patients (7.06%). Of these, 73 (10 M, 63F) accepted to undergo NVC. An autoimmune disease was found in 35 patients (47.9%), of which 2 were underweight, 14 normal weight and 19 overweight. Of 38 patients with primary RP,3 were underweight, 23 normal weight and 12 overweight. BMI was significantly higher in secondary RP (p=0.03). Overweight patients with secondary RP were older (p=0.01), but with a disease duration not statistically significant longer (p=0.26). In secondary RP, avascular areas and neoangiogenesis were founded only in overweight patients. Moreover,in secondary RP overweight was correlated with decreased capillary density (p=0-04). There was not association between BMI and capillaroscopic abnormalities in primary RP.Conclusion:In our study BMI was correlated with microvascular changes only in patients with secondary RP. Our findings may suggests a role for obesity in the microcirculatory disfunction in the autoimmune diseases. Further studies are needed to generalize results and to find a causative role.

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