Background Spondyloarthritis (SpA) is associated with an increased cardiovascular risk. Abdominal adiposity, especially visceral adipose tissue (VAT) is emerging as a independent cardio-metabolic risk factor.
Objectives Our study aimed at assessing association between VAT and cardiovascular risk factors in patients with early or long-standing SpA.
Methods This study was performed in patients recruited from 2 cohorts of SpA: COMOSPA (long-standing SpA) and DESIR (early SpA).
VAT was measured by total body dual energy X-ray absorptiometry in patients with SpA, at baseline in the COMOSPA cohort; at baseline and after 2 years of follow-up in the DESIR cohort. We also collected the following items: demographic data, disease characteristics, current treatment, inflammation biomarkers, cardiovascular risks (BMI, smoking status, hypertension, diabetes, hypercholesterolemia and hypertriglyceridemia) and cardiovascular events (history of ischemic cardiovascular disease).
We, first, compared VAT values in these 2 groups of patients, then, searched for an association between VAT and cardiovascular risks, and finally, studied 2-year VAT variations for patients in the DESIR cohort.
Results 82 patients and 129 patients from COMOSPA and DESIR cohorts were included respectively. In COMOSPA, patients were mostly males (68.3% vs. 55.6%), older (46.3±12.8 vs. 33.0±8.6 years old), with a longer duration of disease (12.0±11.2 vs. 1.5±0.9 years), and received more frequently TNF-blockers (64.6% vs. 30.2%), as compared to DESIR cohort (all p<0.02).
SpA patients of COMOSPA cohort had more frequently hypertension (34.1% vs. 3.1%, p<0.01), dyslipidemia (43.9% vs. 7.0%, p<0.01), current smoking (34.1% vs. 32.6%, p<0.01) and tended to have a higher BMI (26.5±5.4 vs. 23.7±3.5 kg/m2, p=0.06) than patients from the DESIR cohort.
Mean VAT was higher in patients of COMOSPA cohort than in DESIR cohort (140.6±75.2 vs. 79.2±44.0 cm2, p<0.01) after adjustment for age.
In patients of COMOSPA cohort, VAT was significantly associated with the presence of dyslipidemia (p=0.02) and high level of LDL cholesterol (p<0.01), after adjustment for age, gender and BMI, in univariate analysis.
In patients of DESIR cohort, baseline VAT was significantly associated with high level of CRP (p=0.04), high consumption of NSAIDs (assessed by NSAIDs score) (p=0.04) and presence of hypertension (p=0.05), after adjustment for age, gender and BMI, in univariate analysis. In patients of DESIR cohort, VAT tended to increase over 2 years from baseline (79.2 vs 82.6 cm2, +1.8%, p=0.054); this variation was significantly associated with SpA responding to ASAS criteria (p=0.01), presence of hypercholesterolemia (p<0.01), presence of hypertriglyceridemia (p<0.01) and 2-year changes of BMI (p<0.01). 2-year VAT variation was similar in patients receiving TNF-blockers or not.
Conclusions This study shows that VAT is higher in patients with long–standing SpA than with early SpA. VAT is associated with to the presence of cardiovascular risk factors, after adjusting on age and BMI in both settings. In addition to BMI, assessing VAT could be a complimentary tool for the assessment of cardiovascular risk in SpA patients.
Disclosure of Interest None declared