title: Relationship of abdominal adiposity and body composition with endothelial dysfunction in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  We aimed to investigate whether the abnormalities in body composition and abdominal fat that occur in rheumatoid arthritis (RA) are associated with the presence of endothelial dysfunction.
  
  
  METHODS
  Cross-sectional study that encompassed 197 women (100 RA patients and 97 age-matched controls). Patients and controls were evaluated to establish endothelial function by brachial artery flow-mediated dilatation (FMD). Dual-x-ray-absorptiometry-derived body composition and abdominal adiposity by magnetic resonance imaging were assessed. Multiple regression analysis was performed to study the relationship between body composition and endothelial function.
  
  
  RESULTS
  FMD was higher in controls compared to RA patients (8.5 [4.5-15.6] % vs. 5.3 [0.0-9.2] %, p=0.00). Appendicular-to-total lean mass ratio (0.42 ± 0.02 vs. 0.40 ± 0.03, p=0.00) and appendicular-to-trunk lean mass (0.82 ± 0.08 vs. 0.78 ± 0.08, p=0.00) were lower in RA patients. Visceral and subcutaneous abdominal fat tissues did not differ between patients and controls. Body mass index over 30 kg/m2 was common in patients and controls (44 and 32%). High sarcopenia tended to be more elevated in RA after multivariate adjustment (13% vs. 7%, p=0.06). Fat mass index showed a negative association (per standard deviation-SD-), after adjusting for comorbidity, with FMD in controls (beta coef. -0.45[-1.05-0.05], p=0.03) but not in patients. Overfat definition (beta coef. -0.81[-1.73-0.00], p=0.05) and visceral fat (per SD beta coef. -0.60 [-1.18-0.02], p=0.04) were associated with a lower FMD values in controls but not in RA patients. Trend analysis revealed that sarcopenia was related to increased endothelial dysfunction in both patients and controls.
  
  
  CONCLUSIONS
  Our findings suggest that fat accumulation is not associated with endothelial dysfunction in RA patients. However, RA patients with sarcopenia are more likely to suffer endothelial dysfunction possibly being at higher cardiovascular risk.
authors.affiliation: Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Delgado-Frías
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain; and University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: González-Gay
authors.affiliation: IMETISA, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Muñiz-Montes
authors.affiliation: Division of Nuclear Medicine, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: María A
authors.initials: MA
authors.lastname: Gómez Rodríguez-Bethencourt
authors.affiliation: Division of Nuclear Medicine, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Antonieta
authors.initials: A
authors.lastname: González-Díaz
authors.affiliation: Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; and Departement of Medicine, School of Medicine, Universidad de La Laguna, Tenerife, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Díaz-González
authors.affiliation: Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain.
authors.forename: Iván
authors.initials: I
authors.lastname: Ferraz-Amaro
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000503:physiopathology*; D001823:Body Composition; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000503:physiopathology; D012107:Research Design; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000503:physiopathology; D013030:Spain; D014463:Ultrasonography; D014652:Vascular Diseases / Q000175:diagnosis / Q000503:physiopathology; D014664:Vasodilation