Skip to main content
SpringerLink
Log in

Relationship between body composition and both cardiovascular risk factors and lung function in systemic sclerosis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The aims of this study were to evaluate body composition in systemic sclerosis (SSc) and to assess its association with the traditional risk factors for atherosclerosis and parameters of lung function. Eighty-six patients affected by SSc (13 men and 73 women, mean age 58.5 years, mean disease duration 10.7 years, 31 with diffuse form and 55 with limited pattern) underwent evaluation of body composition using a dual-energy X-ray (DXA) fan beam densitometer (GE Lunar iDXA) in order to assess total and regional body fat mass and fat-free mass. Clinical features, pulmonary function parameters, and the concomitant presence of the traditional cardiovascular risk factors were recorded. Android fat resulted to be higher in SSc patients with coexistence of hypercholesterolemia (P = 0.021), hypertension (P = 0.028), and overweight/obesity (P < 0.001) and positively correlated with body mass index (P < 0.001). Forced vital capacity (FVC) was inversely correlated with android fat (P = 0.034) and with the android fat/gynoid fat ratio (P = 0.013) and positively correlated with android lean (P = 0.041); the correlations were improved when FVC data were adjusted for sex, age, disease duration, and smoking habits (P = 0.010 for android fat, P = 0.010 for android fat/gynoid fat ratio, P = 0.011 for android lean). In this study, we showed that visceral abdominal fat, measured by DXA, is correlated with the main cardiovascular risk factors and lung volumes in SSc patients. Longitudinal studies are needed to evaluate if decrease of abdominal fat would improve lung function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Souza RBC, Borges CTL, Takayama L, Aldroghi JM, Pereira RMR (2006) Systemic sclerosis and bone loss: the role of the disease and body composition. Scand J Rheumatol 35:374–377

    Article  Google Scholar 

  2. Krause L, Becker MO, Brueckner CS, Bellinghausen CJ, Becker C, Schneider U et al (2010) Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis. Ann Rheum Dis 69:1951–1957

    Article  PubMed  Google Scholar 

  3. Subcommittee for scleroderma criteria of the American Rheumatism Association diagnostic and therapeutic criteria committee (1980) Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 23:581–590

    Article  Google Scholar 

  4. LeRoy EC, Black CM, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr et al (1988) Scleroderma (systemic sclerosis): classification, subsets, and pathogenesis. J Rheumatol 15:202–205

    CAS  PubMed  Google Scholar 

  5. Akesson A, Fiori G, Krieg T, van den Hoogen FHJ, Seibold JR (2002) Assessment of skin, joint, tendon, and muscle involvement. Clin Exp Rheumatol 21(suppl 29):S5–S8

    Google Scholar 

  6. Kelly TL, Berger R, Richardson TL (1988) DXA body composition: theory and practice. Appl Radiat Isot 49:511–513

    Article  Google Scholar 

  7. Cutolo M, Sulli A, Pizzorni C, Accardo S (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160

    CAS  PubMed  Google Scholar 

  8. Alberti KG, Zimmet PZ (1998) Definition, diagnosis, and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553

    Article  CAS  PubMed  Google Scholar 

  9. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al (2007) 2007 Guidelines for the management of arterial hypertension: the task force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25:1105–1187

    Article  CAS  PubMed  Google Scholar 

  10. Executive summary of the third report of the national cholesterol education program (NCEP) (2001) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 285:2486–2497

    Article  Google Scholar 

  11. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY et al (2007) Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 116:39–48

    Article  PubMed  Google Scholar 

  12. Canoy D (2008) Distribution of body fat and risk of coronary heart disease in men and women. Curr Opin Cardiol 23:591–598

    Article  PubMed  Google Scholar 

  13. Ibrahim MM (2010) Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev 11:11–18

    Article  PubMed  Google Scholar 

  14. Dandona P, Aljada A, Bandyopadhyay A (2004) Inflammation: the link between insulin resistance, obesity, and diabetes. Trends Immunol 25:4–7

    Article  CAS  PubMed  Google Scholar 

  15. Veale DJ, Collidge TA, Belch JJ (1995) Increased prevalence of symptomatic macrovascular disease in systemic sclerosis. Ann Rheum Dis 54:853–855

    Article  CAS  PubMed  Google Scholar 

  16. Ho M, Veale D, Eastmond C, Nuki G, Belch J (2000) Macrovascular disease and systemic sclerosis. Ann Rheum Dis 59:39–43

    Article  CAS  PubMed  Google Scholar 

  17. Ozbalkan Z, Efe C, Cesur M, Ertek S, Nasiroglu N, Berneis K et al (2010) An update on the relationships between rheumatoid arthritis and atherosclerosis. Atherosclerosis 212:377–382

    Article  CAS  PubMed  Google Scholar 

  18. Sherer Y, Zinger H, Shoenfeld Y (2010) Atherosclerosis in systemic lupus erythematosus. Autoimmunity 43:98–102

    Article  CAS  PubMed  Google Scholar 

  19. Nussinovitch U, Shoenfeld Y (2011) Atherosclerosis and macrovascular involvement in systemic sclerosis: myth or reality. Autoimmun Rev 10:259–266

    Article  PubMed  Google Scholar 

  20. Au K, Singh MK, Bodukam V, Bae S, Maranian P, Ogawa R et al (2011) Atherosclerosis in systemic sclerosis: a systematic review and meta-analysis. Arthritis Rheum 63:2078–2090

    Article  PubMed Central  PubMed  Google Scholar 

  21. Caramaschi P, Martinelli N, Biasi D, Carletto A, Faccini G, Volpe A et al (2003) Homocysteine plasma level is related to the severity of lung impairment in scleroderma. J Rheumatol 30:298–304

    CAS  PubMed  Google Scholar 

  22. Herrick AL, Illingworth KJ, Hollis S, Gomez-Zumaquero JM, Tinahones FJ (2001) Antibodies against oxidized low-density lipoproteins in systemic sclerosis. Rheumatology (Oxford) 40:401–405

    Article  CAS  Google Scholar 

  23. Lippi G, Caramaschi P, Montagnana M, Salvagno GL, Volpe A, Guidi G (2006) Lipoprotein[a] and the lipid profile in patients with systemic sclerosis. Clin Chim Acta 364:345–348

    Article  CAS  PubMed  Google Scholar 

  24. Khurma V, Meyer C, Park GS, McMahon M, Lin J, Singh RR et al (2008) A pilot study of subclinical coronary atherosclerosis in systemic sclerosis: coronary artery calcification in cases and controls. Arthritis Rheum 59:591–597

    Article  CAS  PubMed  Google Scholar 

  25. Youssef P, Brama T, Englert H, Bertouch J (1995) Limited scleroderma is associated with increased prevalence of macrovascular disease. J Rheumatol 22:469–472

    CAS  PubMed  Google Scholar 

  26. Nihtyanova SI, Brough GM, Balck CM, Denton CP (2008) Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis. Ann Rheum Dis 67:120–123

    Article  CAS  PubMed  Google Scholar 

  27. Caramaschi P, Biasi D, Caimmi C, Barausse G, Sabbagh D, Tinazzi I et al (2012) Digital amputation in systemic sclerosis: prevalence and clinical associations. A retrospective longitudinal study. J Rheumatol 39:1648–1653

    Article  PubMed  Google Scholar 

  28. Rossi AP, Watson NL, Newman AB, Harris TB, Kritchevsky SB, Bauer DC et al (2011) Effects of body composition and adipose tissue distribution on respiratory function in elderly men and women: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci 66:801–808

    Article  PubMed  Google Scholar 

  29. Chen Y, Rennie D, Cormier YF, Dosman J (2007) Waist circumference is associated with pulmonary function in normal-weight, overweight, and obese subjects. Am J Clin Nutr 85:35–39

    CAS  PubMed  Google Scholar 

  30. Babb TG, Wyrick BL, DeLorey DS, Chase P, Feng MY (2008) Fat distribution and end-expiratory lung volume in lean and obese men and women. Chest 134:704–711

    Article  PubMed  Google Scholar 

  31. Canoy D, Luben R, Welch A, Bingham S, Wareham N, Day N et al (2004) Abdominal obesity and respiratory function in men and women in the EPIC-Norfolk Study, United Kingdom. Am J Epidemiol 159:1140–1149

    Article  CAS  PubMed  Google Scholar 

  32. Park YS, Kwon HT, Hwang SS, Choi SH, Cho YM, Lee J et al (2011) Impact of visceral adiposity measured by abdominal computed tomography on pulmonary function. J Korean Med Sci 26:771–777

    Article  PubMed Central  PubMed  Google Scholar 

  33. Chambers EC, Heshka S, Huffaker LY, Xiong Y, Wang J, Eden E et al (2008) Truncal adiposity and lung function in older black women. Lung 186:13–17

    Article  PubMed  Google Scholar 

  34. Koziel S, Ulijaszek SJ, Szklarska A, Bielicki T (2007) The effects of fatness and fat distribution on respiratory functions. Ann Hum Biol 34:123–131

    Article  PubMed  Google Scholar 

  35. Harik-Khan R, Wise RA, Lou C, Morrell CH, Brant LJ, Fozard JL (1999) The effect of gender on the relationship between body fat distribution and lung function. Respir Med 93:382–388

    Article  CAS  PubMed  Google Scholar 

  36. Sugerman HJ (2001) Effects of increased intra-abdominal pressure in severe obesity. Surg Clin North Am 81:1063–1075

    Article  CAS  PubMed  Google Scholar 

  37. Ochs-Balcom HM, Grant BJ, Muti P, Sempos CT, Freudenheim JL, Trevisan M et al (2006) Pulmonary function and abdominal adiposity in the general population. Chest 129:853–862

    Article  PubMed  Google Scholar 

  38. Sharp JT, Druz WS, Kondragunta VR (1986) Diaphragmatic responses to body position changes in obese patients with obstructive sleep apnea. Am Rev Respir Dis 133:32–37

    CAS  PubMed  Google Scholar 

  39. Bottai M, Pistelli F, Di Pede F, Carrozzi L, Baldacci S, Matteelli G et al (2002) Longitudinal changes of body mass index, spirometry, and diffusion in a general population. Eur Respir J 20:665–673

    Article  CAS  PubMed  Google Scholar 

  40. Chen Y, Horne SL, Dosman JA (1993) Body weight and weight gain related to pulmonary function decline in adults: a 6 year follow up study. Thorax 48:375–380

    Article  CAS  PubMed  Google Scholar 

  41. Rossi A, Fantin F, Di Francesco V, Guariento S, Giuliano K, Fontana G et al (2008) Body composition and pulmonary function in the elderly: a 7-year longitudinal study. Int J Obes (Lond) 32:1423–1430

    Article  CAS  Google Scholar 

  42. Aaron SD, Fergusson D, Dent R, Chen Y, Vandemheen KL, Dales RE (2004) Effect of weight reduction on respiratory function and airway reactivity in obese women. Chest 125:2046–2052

    Article  PubMed  Google Scholar 

  43. Oka R, Miura K, Sakurai M, Nakamura K, Yagi K, Miyamoto S et al (2010) Impacts of visceral adipose tissue and subcutaneous adipose tissue on metabolic risk factors in middle-aged Japanese. Obesity (Silver Spring) 18:153–160

    Article  CAS  Google Scholar 

  44. Preis SR, Massaro JM, Robins SJ, Hoffmann U, Vasan RS, Irlbeck T et al (2010) Abdominal subcutaneous and visceral adipose tissue and insulin resistance in the Framingham heart study. Obesity (Silver Spring) 18:2191–2198

    Article  Google Scholar 

  45. Kuhn C 3rd, Homer RJ, Zhu Z, Ward N, Flavell RA, Geba GP et al (2000) Airway hyper responsiveness and airway obstruction in transgenic mice. Morphologic correlates in mice overexpressing interleukin (IL)-11 and IL-6 in the lung. Am J Respir Cell Mol Biol 22:289–295

    Article  CAS  PubMed  Google Scholar 

  46. Steen VD, Medsger TA (2007) Changes in causes of death in systemic sclerosis, 1972–2002. Ann Rheum Dis 66:940–944

    Article  PubMed  Google Scholar 

  47. Tyndall AJ, Bannert B, Vonk M, Airò P, Cozzi F, Carreira PE et al (2010) Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database. Ann Rheum Dis 69:1809–1815

    Article  PubMed  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

  1. Rheumatology Unit, University of Verona, Verona, Italy

    Paola Caramaschi, Domenico Biasi, Cristian Caimmi, Giovanni Barausse, Davide Gatti, Sara Pieropan, Dania Sabbagh & Silvano Adami

  2. Internal Medicine, University of Verona, Verona, Italy

    Marcello Ferrari

  3. Unità di Reumatologia, Policlinico G.B. Rossi, Piazzale Scuro, 37134, Verona, Italy

    Paola Caramaschi

Authors
  1. Paola Caramaschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Domenico Biasi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cristian Caimmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giovanni Barausse
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Davide Gatti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marcello Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sara Pieropan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dania Sabbagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Silvano Adami
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paola Caramaschi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Caramaschi, P., Biasi, D., Caimmi, C. et al. Relationship between body composition and both cardiovascular risk factors and lung function in systemic sclerosis. Clin Rheumatol 33, 77–82 (2014). https://doi.org/10.1007/s10067-013-2388-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-013-2388-y

Keywords

Search

Navigation