Department of Rheumatology, The First Affiliated Hospital of Jinan University, No. 613 West Huangpu Ave, Tianhe District, Guangzhou, 510630, China.
Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Clin Rheumatol. 2019 Nov;38(11):3117-3127. doi: 10.1007/s10067-019-04701-3. Epub 2019 Jul 30.
Visceral adipose tissue (VAT) is becoming a recognized cardiovascular (CV) risk factor. This study aimed to evaluate body composition, especially VAT, in systemic lupus erythematosus (SLE) and to explore the association between VAT and SLE disease-related factors.
Ninety-eight inpatients with SLE and 108 age- and body mass index (BMI)-matched healthy controls were included. Demographic and clinical parameters were recorded. The VAT was measured by dual-energy x-ray absorptiometry.
The mean age and disease duration of patients were 46.4 ± 13.0 years and 8.0 ± 7.0 years, respectively. Patients with SLE had higher VAT volume (p = 0.0015) and mass (p = 0.0017) than controls, especially in premenopausal and postmenopausal groups. The subanalysis of subjects with BMI less than 25 kg/m indicated that patients had lower lean mass (p = 0.0005), fat-free mass (p = 0.0005), and fat-free mass index (p = 0.0001), but increased adiposity distribution than controls, including VAT volume and mass. However, overweight/obese patients had similar body composition with controls. The VAT volume correlated with BMI, age, menopausal status, hypertension, uric acid, creatinine, non-high-density lipoprotein cholesterol, and triglyceride in both groups. In the patient group, the VAT volume correlated with disease duration, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR-DI), and low serum complement, but not with SLEDAI and glucocorticoid dose.
This study suggested that SLE patients had some traditional CV risk factors such as altered body composition and increased VAT. The higher VAT in patients with SLE was associated with traditional cardiometabolic risks, which may contribute to CV events in SLE populations. Key Points • Patients with SLE had increased VAT volume and mass than controls. • The VAT volume correlated with traditional cardiometabolic risk factors. • In SLE patient group, the VAT volume correlated with disease duration, SLICC/ACR-DI, and low serum complementC3/C4, but not with SLEDAI and glucocorticoid dose.
内脏脂肪组织（VAT）正成为公认的心血管（CV）危险因素。本研究旨在评估系统性红斑狼疮（SLE）患者的身体成分，特别是 VAT，并探讨 VAT 与 SLE 疾病相关因素之间的关系。
纳入 98 例 SLE 住院患者和 108 例年龄和体重指数（BMI）匹配的健康对照者。记录人口统计学和临床参数。采用双能 X 线吸收法测量 VAT。
患者的平均年龄和病程分别为 46.4±13.0 岁和 8.0±7.0 年。SLE 患者的 VAT 体积（p=0.0015）和质量（p=0.0017）均高于对照组，尤其是在绝经前和绝经后组。BMI＜25kg/m2 的受试者亚分析表明，患者的瘦体重（p=0.0005）、去脂体重（p=0.0005）和去脂体重指数（p=0.0001）较低，但脂肪分布增加，包括 VAT 体积和质量。然而，超重/肥胖患者与对照组的身体成分相似。VAT 体积与两组的 BMI、年龄、绝经状态、高血压、尿酸、肌酐、非高密度脂蛋白胆固醇和甘油三酯相关。在患者组中，VAT 体积与病程、系统性红斑狼疮国际合作诊所/美国风湿病学会损伤指数（SLICC/ACR-DI）和低血清补体相关，但与 SLEDAI 和糖皮质激素剂量无关。
本研究表明，SLE 患者存在一些传统的心血管危险因素，如身体成分改变和 VAT 增加。SLE 患者较高的 VAT 与传统的心血管代谢危险因素相关，这可能导致 SLE 人群发生心血管事件。
SLE 患者的 VAT 体积和质量大于对照组。
VAT 体积与传统心血管代谢危险因素相关。
在 SLE 患者组中，VAT 体积与病程、SLICC/ACR-DI 和低血清补体 C3/C4 相关，但与 SLEDAI 和糖皮质激素剂量无关。
