University Hospital of Besançon, Clinical Investigation Center for Biotherapy INSERM CBT-506, FHU INCREASE , Besançon , France ; Department of Rheumatology, University Hospital of Besançon , Besançon , France ; Department of Therapeutics, University of Franche Comté , Besançon , France ; University of Franche Comté, UPRES EA 4266 «Pathogens and Inflammation» SFR FED 4234 , Besançon , France ; LabEX LipSTIC, ANR-11-LABX-0021 , Besançon , France.
University Hospital of Besançon, Endocrine and Metabolic Biochemistry , Besançon , France ; University of Franche Comté, UPRES EA 3920 "Cardiovascular Pathophysiology and Prevention", SFR FED 4234 , Besançon , France.
Front Immunol. 2013 Dec 13;4:453. doi: 10.3389/fimmu.2013.00453. eCollection 2013.
Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC), with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW) isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR) and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS, and 51 HC). Body composition was measured using dual-energy X-ray absorptiometry to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p = 0.01) while visceral fat was also increased, but only in women (p = 0.01). Patients with AS tended to have lower total fat mass (p = 0.07) and higher lean mass compared to HC (p = 0.07). Leptin and leptin/fat mass were decreased in male patients with AS (p < 0.01), while total adiponectin and the ratio of HMW to total adiponectin were both increased in RA (p < 0.01). There were no changes in serum resistin and ghrelin in any group of patients. HOMA-IR and the atherogenic index were not modified in RA and AS. These results confirm that body composition was altered in RA and AS, affecting distinct soft tissue compartments. The effect of the increased visceral adipose tissue on cardiovascular risk is presumably attenuated by the favorable cardiometabolic profile in women with RA, as suggested by the normal HOMA-IR and atherogenic index.
类风湿关节炎 (RA) 和强直性脊柱炎 (AS) 是可能改变身体成分的炎症性风湿病。脂肪组织具有释放广泛参与生理功能的产品的能力，但也参与各种病理过程，包括炎症/免疫反应。RA 和 AS 均与心血管并发症的发生有关。已经证实，中心/腹部，特别是腹腔内或内脏肥胖与心血管事件密切相关。因此，在这项研究中，我们旨在评估 RA 或 AS 患者与健康对照组 (HC) 的身体成分，特别强调内脏区域。同时，我们测量了脂肪产物或脂肪因子，即瘦素、脂联素及其高分子量 (HMW) 同工型、抵抗素和胃肽生长激素释放肽，其在能量平衡中起作用。胰岛素抵抗的稳态模型评估 (HOMA-IR) 和动脉粥样硬化指数用于评估心血管风险。共纳入 112 名受试者（30 名 RA 患者、31 名 AS 患者和 51 名 HC）。使用双能 X 射线吸收法测量身体成分，以确定总脂肪量和瘦体重、肥胖、安卓和女性区域的脂肪以及内脏脂肪。患者和 HC 在体重指数方面没有差异。相反，RA 患者的肥胖程度增加（p=0.01），而女性的内脏脂肪也增加（p=0.01）。与 HC 相比，AS 患者的总脂肪量趋于较低（p=0.07），瘦体重较高（p=0.07）。AS 男性患者的瘦素和瘦素/脂肪量降低（p<0.01），而 RA 患者的总脂联素和 HMW 与总脂联素的比例均增加（p<0.01）。任何一组患者的血清抵抗素和胃饥饿素均无变化。RA 和 AS 患者的 HOMA-IR 和动脉粥样硬化指数没有改变。这些结果证实，RA 和 AS 改变了身体成分，影响了不同的软组织隔室。RA 女性正常的 HOMA-IR 和动脉粥样硬化指数表明，增加的内脏脂肪组织对心血管风险的影响可能被有利的心脏代谢特征所减弱。
