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Visceral adipose tissue in granulomatosis with polyangiitis: association with disease activity parameters

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Abstract

Objective

To assess the body composition (BC) of patients with granulomatosis with polyangiitis (GPA) compared to healthy controls, emphasizing visceral adipose tissue (VAT) and associated BC parameters with disease activity, the damage index, and inflammatory parameters in patients with GPA.

Methods

This study was conducted in 43 patients with GPA and 43 healthy controls matched by sex, age, and body mass index (BMI). BC was analyzed using dual-energy X-ray absorptiometry (DXA). The fat mass parameters evaluated were total fat mass (FM), adiposity (%), the fat mass index (FMI: fat mass/ht2), and VAT (g, cm2, cm3). Disease activity was assessed by the Birmingham Vasculitis Activity Score (BVAS). Damage was assessed by the Vasculitis Damage Index (VDI). C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured.

Results

Comparing patients with GPA with healthy controls, patients had a significantly greater VAT (VAT in g: 685.81 ± 306.10 vs. 581.21 ± 235.57, p = 0.04; VAT in cm2: 142.23 ± 63.48 vs. 119.84 ± 49.54, p = 0.03; VAT in cm3: 741.33 ± 330.97 vs. 628.44 ± 254.66, p = 0.04). Patients with higher VAT (≥ 768 g) had an increased value of ESR (22.77 ± 26.79 vs. 11.57 ± 11.30 mm/1st hour, p = 0.04) and an increased value of BVAS (3.18 ± 4.15 vs. 0.90 ± 1.70, p = 0.01) when compared to patients with less VAT (< 768 g).

Conclusion

Patients with GPA have altered BC compared to healthy controls. Moreover, higher VAT was associated with disease activity and higher inflammatory markers, suggesting a relationship between GPA activity and adiposity parameters.

Key points

• Granulomatosis with polyangiitis patients have increased visceral adipose tissue when compared to health controls;

• Granulomatosis with polyangiitis patients with higher values of visceral adipose tissue have worse disease activity and higher inflammatory markers;

• This paper represents important contribution to the well-studied association between vasculitis and inflammatory markers, adding the role of adipose visceral tissue in the disease physiopathology.

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Data availability

The data used in this study is available under considerations of patient privacy principles.

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Funding

Programa de Iniciação Científica e de Iniciação em Desenvolvimento Tecnológico e Inovação da USP (PIBIC) (P.L.F.); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) #305556/2017-7 (R.M.R.P).

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Author notes

  1. Pedro L. Furlam and Mariana O. Perez contributed equally to this work.

Authors and Affiliations

  1. Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil

    Pedro L. Furlam, Mariana O. Perez, Andre S. Franco, Valeria F. Caparbo, Samuel K. Shinjo & Rosa M. R. Pereira

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  1. Pedro L. Furlam
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  2. Mariana O. Perez
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Corresponding author

Correspondence to Rosa M. R. Pereira.

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Ethics approval

The study was approved by the Research Ethics Committee of Clinics Hospital, University of Sao Paulo, School of Medicine, under the following number: 2.723.911.

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All participants enrolled in the study signed a full consent form, previous approved by our local Ethics Committee.

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Furlam, P.L., Perez, M.O., Franco, A.S. et al. Visceral adipose tissue in granulomatosis with polyangiitis: association with disease activity parameters. Clin Rheumatol 40, 2835–2841 (2021). https://doi.org/10.1007/s10067-021-05592-z

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  • DOI: https://doi.org/10.1007/s10067-021-05592-z

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