title: Early increase of abdominal adiposity in patients with spondyloarthritis receiving anti-tumor necrosis factor-α treatment.
abstract: OBJECTIVE
  Patients with spondyloarthritis (SpA) receiving anti-TNF-α treatment have an increase in fat mass. This may be relevant to cardiovascular risk. The aim of this study was to estimate visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) changes by dual-energy x-ray absorptiometry (DEXA) in patients with SpA under anti-TNF-α therapy.
  
  
  METHODS
  We used an ancillary protocol to an open, prospective 2-year followup study of patients with SpA. Waist circumference (WC), body weight, body mass index, VAT, and SAT were measured at baseline, 6 months, and 1 and 2 years. Univariate and multivariate analyses were performed to assess variables associated with VAT and SAT changes.
  
  
  RESULTS
  A total of 85 patients were analyzed. Patients were 39.3 ± 11.4 years old and mean baseline Bath Ankylosing Spondylitis Disease Activity Index was 55.0 ± 20.2. Treatment was effective according to clinical and biological variables, and body weight increased by 0.9 ± 1.7 kg over 2 years. There was a significant gain in VAT after 6 months (13.7 ± 20.6 cm(2), p < 0.0001), 1 year (21.0 ± 26.6 cm(2), p < 0.0001), and after 2 years (29.1 ± 33.4 cm(2), p < 0.0001); and in SAT after 6 months (12.5 ± 27.4 cm(2), p < 0.0001), 1 year (27.1 ± 38.2 cm(2), p < 0.0001), and after 2 years (31.9 ± 53.2 cm(2), p < 0.0001). We could not find any determinant of these changes by multivariate analysis.
  
  
  CONCLUSIONS
  In patients with SpA receiving anti-TNF-α therapy, there is an early significant increase in abdominal obesity with significant increase in both VAT and SAT after 1 and 2 years of treatment. Prospective studies are required to investigate the relationship between these changes and cardiovascular risk.
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center. ihsane.hmamouchi@gmail.com.
authors.forename: Ihsane
authors.initials: I
authors.lastname: Hmamouchi
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center.
authors.forename: Christian
authors.initials: C
authors.lastname: Roux
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center.
authors.forename: Simon
authors.initials: S
authors.lastname: Paternotte
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center.
authors.forename: Sami
authors.initials: S
authors.lastname: Kolta
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.affiliation: From the Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, Paris, France; Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology, Rabat, Morocco.I. Hmamouchi, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center, and Mohammed V-Souissi University, Faculty of Medicine, Laboratory of Biostatistics, Clinical Research and Epidemiology; C. Roux, MD, PhD; S. Paternotte, MD; S. Kolta, MD; M. Dougados, MD, PhD; K. Briot, MD, PhD, Paris Descartes University, Department of Rheumatology, Cochin Hospital, and Epidemiology and Biostatistics Unit, Sorbonne Paris Cité Research Center.
authors.forename: Karine
authors.initials: K
authors.lastname: Briot
mesh_terms: D050153:Abdominal Fat / Q000000981:diagnostic imaging / Q000187:drug effects*; D050154:Adiposity / Q000187:drug effects*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D015992:Body Mass Index; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000139:chemically induced / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012307:Risk Factors; D025241:Spondylarthritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055105:Waist Circumference
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068800:Etanercept
keywords: ABDOMINAL ADIPOSITY; ANTI-TUMOR NECROSIS FACTOR-α; SPONDYLOARTHRITIS; SUBCUTANEOUS ADIPOSE TISSUE; VISCERAL ADIPOSE TISSUE