Psoriatic arthritis with abnormal mass composition linked to heart attack, Diabetes

Increased BMI is strongly associated with PsA. The site of fat storage is important as visceral adipose tissue (VAT) and ectopic fat including fat in the liver and skeletal muscle are associated with increased metabolic risk. Body composition profiling with MRI allows detailed assessment of body fat distribution including quantification of abdominal subcutaneous adipose tissue (ASAT), VAT, ectopic fat including liver fat and muscle fat infiltration (MFI), as well as fat-free thigh muscle volume (FFMV).

So, the researchers aimed to characterize for the first time the detailed body composition profile of PsA using MRI compared with age, sex and BMI-matched metabolic disease free (MDF) controls and type 2 diabetes, and to relate body composition to propensity for CHD and type 2 diabetes in PsA vs MDF controls.

For the current study,Detailed MRI body composition profiles of 26 PsA participants from the IMAPA study were compared with 130 age, sex and BM-matched MDF controls and 454 individuals with type 2 diabetes from UK Biobank. The body-composition predicted propensity for coronary heart disease (CHD) and type 2 diabetes was compared between PsA and matched MDF controls.

On analysis, the following facts emerged.

• PsA participants had a significantly greater visceral adipose tissue (VAT) volume [mean 5.89 l (S.D. 2.10 l)] compared with matched-MDF controls [mean 4.34 l (S.D. 1.83 l)] (P <0.001) and liver fat percentage [median 8.88% (interquartile range 4.42–13.18%)] compared with MDF controls [3.29% (1.98–7.25%)] (P <0.001).
• These differences remained significant after adjustment for age, sex and BMI.
• There were no statistically significant differences in VAT, liver fat or muscle fat infiltration (MFI) between PsA and type 2 diabetes.
• PsA participants had a lower thigh muscle volume than MDF controls and those with type 2 diabetes.
• Body composition-predicted propensity for CHD and type 2 diabetes was 1.27 and 1.83 times higher, respectively, for PsA compared with matched-MDF controls.

The researchers made some key observations based on the results.

· PsA patients have greater visceral and ectopic liver fat, and lower thigh-muscle volume, than metabolic-disease-free controls.

· This adverse body fat distribution is associated with greater propensity to type 2 diabetes and CHD.

· This study supports the need for weight loss interventions in PsA to lessen cardiometabolic risk.

"Individuals with PsA have an adverse body composition phenotype with greater visceral and ectopic liver fat and lower thigh muscle volume than matched MDF controls. Body fat distribution in PsA is more in keeping with the pattern observed in type 2 diabetes and is associated with greater propensity to cardiometabolic disease. These data support the need for greater emphasis on weight loss in PsA management to lessen CHD and type 2 diabetes risk."wrote the team.For the full article follow the link: https://doi.org/10.1093/rheumatology/keaa604

Primary source: Rheumatology