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Title: Non-obese visceral adiposity is associated with the risk of atherosclerosis in Japanese patients with rheumatoid arthritis: a cross-sectional study
Authors: Yoshida, Tamami
Hashimoto, Motomu  kyouindb  KAKEN_id
Kawahara, Rie
Yamamoto, Hiroko
Tanaka, Masao  kyouindb  KAKEN_id  orcid (unconfirmed)
Ito, Hiromu
Masuda, Izuru
Hosoda, Kiminori
Yamamoto, Wataru
Uozumi, Ryuji  kyouindb  KAKEN_id  orcid (unconfirmed)
Morita, Satoshi
Fujii, Yasutomo
Mimori, Tsuneyo
Nin, Kazuko  kyouindb  KAKEN_id  orcid (unconfirmed)
Author's alias: 橋本, 求
田中, 真生
伊藤, 宣
魚住, 龍史
森田, 智視
藤井, 康友
三森, 経世
任, 和子
Keywords: Rheumatoid arthritis
Intra-abdominal fat
Issue Date: Sep-2018
Publisher: Springer Verlag
Journal title: Rheumatology International
Volume: 38
Issue: 9
Start page: 1679
End page: 1689
Abstract: Rheumatoid arthritis (RA) patients often have altered body composition including reduced muscle mass and increased fat mass. Some RA patients are likely to increase visceral fat without obesity [Body Mass Index (BMI) ≥ 25]. The objective of the study was to determine the association between obesity and/or visceral adiposity and the risk for atherosclerosis in Japanese RA patients. Obesity was evaluated using the BMI, with visceral adiposity evaluated using the visceral fat area (VFA) and the visceral/subcutaneous fat ratio (V/S ratio), quantified using the dual bioelectrical impedance method. Atherosclerosis was evaluated based on the intima–media thickness (IMT) and Plaque score (PS) of the carotid artery, measured using ultrasonography. Multivariate analysis was performed to determine the factors associated with IMT and PS. IMT and PS were compared among groups of patients sub-classified according to BMI and VFA levels. The V/S ratio was higher in RA patients than healthy controls, after adjustment for age, BMI, and waist circumference. On multivariate analysis, the V/S ratio, but not the BMI, was independently associated with the IMT and PS. Among the sub-classifications for BMI and VFA, non-obese patients with a high visceral adiposity (18.5 ≤ BMI < 25 kg/m² and VFA ≥ 100 cm²) had the highest IMT (mean IMT, 0.93 ± 0.29 mm; maximum IMT, 1.44 ± 0.71 mm) and PS (1.43 ± 0.61), compared to all other BMI and VFA subgroups. RA patients have increased visceral adiposity, which is associated with a high prevalence of atherosclerotic of plaques. Non-obese RA patients who have visceral adiposity have a specifically higher risk for atherosclerosis.
Rights: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
DOI(Published Version): 10.1007/s00296-018-4095-0
PubMed ID: 29974186
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