Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
AMRA Medical, Linköping, Sweden.
Rheumatology (Oxford). 2021 Apr 6;60(4):1858-1862. doi: 10.1093/rheumatology/keaa604.
To compare body composition in PsA with metabolic disease free (MDF) controls and type 2 diabetes and assess body-composition predicted propensity for cardiometabolic disease.
Detailed MRI body composition profiles of 26 PsA participants from the IMAPA study were compared with 130 age, sex and BMI-matched MDF controls and 454 individuals with type 2 diabetes from UK Biobank. The body-composition predicted propensity for coronary heart disease (CHD) and type 2 diabetes was compared between PsA and matched MDF controls.
PsA participants had a significantly greater visceral adipose tissue (VAT) volume [mean 5.89 l (s.d. 2.10 l)] compared with matched-MDF controls [mean 4.34 l (s.d. 1.83 l)] (P <0.001) and liver fat percentage [median 8.88% (interquartile range 4.42-13.18%)] compared with MDF controls [3.29% (1.98-7.25%)] (P <0.001). These differences remained significant after adjustment for age, sex and BMI. There were no statistically significant differences in VAT, liver fat or muscle fat infiltration (MFI) between PsA and type 2 diabetes. PsA participants had a lower thigh muscle volume than MDF controls and those with type 2 diabetes. Body composition-predicted propensity for CHD and type 2 diabetes was 1.27 and 1.83 times higher, respectively, for PsA compared with matched-MDF controls.
Individuals with PsA have an adverse body composition phenotype with greater visceral and ectopic liver fat and lower thigh muscle volume than matched MDF controls. Body fat distribution in PsA is more in keeping with the pattern observed in type 2 diabetes and is associated with greater propensity to cardiometabolic disease. These data support the need for greater emphasis on weight loss in PsA management to lessen CHD and type 2 diabetes risk.
比较银屑病关节炎（PsA）患者与无代谢疾病（MDF）对照者及 2 型糖尿病患者的身体成分，并评估身体成分预测心血管代谢疾病的易感性。
比较来自 IMAPA 研究的 26 例 PsA 患者与 130 例年龄、性别和 BMI 匹配的 MDF 对照者以及 UK Biobank 中 454 例 2 型糖尿病患者的详细 MRI 身体成分谱。比较 PsA 患者与匹配的 MDF 对照者的身体成分预测冠心病（CHD）和 2 型糖尿病的易感性。
与匹配的 MDF 对照者相比，PsA 患者的内脏脂肪组织（VAT）体积[平均 5.89L（标准差 2.10L）]明显更大（P<0.001），肝脏脂肪百分比[中位数 8.88%（四分位间距 4.42-13.18%）]也明显更高（P<0.001）。调整年龄、性别和 BMI 后，这些差异仍然显著。PsA 患者与 2 型糖尿病患者的 VAT、肝脏脂肪或肌肉脂肪浸润（MFI）之间无统计学显著差异。与 MDF 对照者和 2 型糖尿病患者相比，PsA 患者的大腿肌肉量更低。与匹配的 MDF 对照者相比，PsA 患者的 CHD 和 2 型糖尿病的身体成分预测易感性分别高 1.27 倍和 1.83 倍。
与匹配的 MDF 对照者相比，PsA 患者的身体成分表型较差，内脏和异位肝脏脂肪更多，大腿肌肉量更少。PsA 患者的体脂分布更符合 2 型糖尿病的模式，与更大的心血管代谢疾病易感性相关。这些数据支持在 PsA 管理中更加强调减肥以降低 CHD 和 2 型糖尿病风险的必要性。
