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More than skin-deep : visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease
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Blake, Tim, Gullick, Nicola J., Hutchinson, Charles E., Bhalerao, Abhir, Wayte, S., Weedall, A. and Barber, Thomas M. (2023) More than skin-deep : visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease. Arthritis Research & Therapy, 25 . 108. doi:10.1186/s13075-023-03085-9 ISSN 1478-6354.
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WRAP-More-than-skin-deep-visceral-fat-disease-metabolic-psoriatic-23.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (3379Kb) | Preview |
Official URL: https://doi.org/10.1186/s13075-023-03085-9
Abstract
Objective
To compare body composition between patients with psoriatic disease (PsD), including cutaneous psoriasis (PsO) and psoriatic arthritis (PsA), and controls, and to explore associations between disease activity and measures of function and metabolic derangement.
Methods
Body composition was assessed by air displacement plethysmography (ADP) and MRI-derived fat segmentation using an automated pipeline (FatSegNet). Function was assessed by Health Assessment Questionnaire (HAQ) and metabolic status by fasting lipid profile, insulin and adiponectin. Active and inactive PsO and PsA were defined by body surface area (BSA) and Psoriasis Area Severity Index (PASI) and minimal disease activity (MDA), respectively.
Results
Thirty patients (median disease duration 15 years; median age 52 years) and 30 BMI-matched controls were enrolled. Compared with controls, all MRI-derived body composition parameters—whole-body volume, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), abdominal adipose tissue (AAT), VAT/AAT and VAT/SAT—were higher in the PsD group, specifically, those with active disease. Body mass, body fat, whole-body volume and whole-body VAT were correlated with higher triglycerides, cholesterol:HDL (high-density lipoprotein), insulin resistance and lower adiponectin as well as higher HAQ and lower MDA.
Conclusions
In this pilot study, patients with PsD revealed excessive total adipose tissue and a greater volume of metabolically unfavourable ectopic fat, including VAT, compared with BMI-matched controls, which also correlated with HAQ, disease activity and overall dysmetabolism. We also provide the first evidence in patients with PsD for the clinical application of FatSegNet: a novel, automated and rapid deep learning pipeline for providing accurate MRI-based measurement of fat segmentation. Our findings suggest the need for a more integrated approach to the management of PsD, which considers both the metabolic and inflammatory burden of disease. More specifically, visceral fat is a surrogate marker of uncontrolled PsD and may be an important future target for both pharmacological and lifestyle interventions.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RL Dermatology |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Psoriasis, Obesity, Human body -- Composition, Psoriatic arthritis, Quality of life, Health | ||||||
| Journal or Publication Title: | Arthritis Research & Therapy | ||||||
| Publisher: | BioMed Central Ltd. | ||||||
| ISSN: | 1478-6354 | ||||||
| Official Date: | 23 June 2023 | ||||||
| Dates: |
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| Volume: | 25 | ||||||
| Article Number: | 108 | ||||||
| DOI: | 10.1186/s13075-023-03085-9 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 20 July 2023 | ||||||
| Date of first compliant Open Access: | 20 July 2023 | ||||||
| RIOXX Funder/Project Grant: |
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