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More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease
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 wa...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288730/ https://www.ncbi.nlm.nih.gov/pubmed/37353811 http://dx.doi.org/10.1186/s13075-023-03085-9 |
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author | Blake, Tim Gullick, Nicola J. Hutchinson, Charles E. Bhalerao, Abhir Wayte, Sarah Weedall, Andrew Barber, Thomas M. |
author_facet | Blake, Tim Gullick, Nicola J. Hutchinson, Charles E. Bhalerao, Abhir Wayte, Sarah Weedall, Andrew Barber, Thomas M. |
author_sort | Blake, Tim |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-023-03085-9. |
format | Online Article Text |
id | pubmed-10288730 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102887302023-06-24 More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease Blake, Tim Gullick, Nicola J. Hutchinson, Charles E. Bhalerao, Abhir Wayte, Sarah Weedall, Andrew Barber, Thomas M. Arthritis Res Ther Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-023-03085-9. BioMed Central 2023-06-23 2023 /pmc/articles/PMC10288730/ /pubmed/37353811 http://dx.doi.org/10.1186/s13075-023-03085-9 Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Blake, Tim Gullick, Nicola J. Hutchinson, Charles E. Bhalerao, Abhir Wayte, Sarah Weedall, Andrew Barber, Thomas M. More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title | More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title_full | More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title_fullStr | More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title_full_unstemmed | More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title_short | More than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
title_sort | more than skin-deep: visceral fat is strongly associated with disease activity, function and metabolic indices in psoriatic disease |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288730/ https://www.ncbi.nlm.nih.gov/pubmed/37353811 http://dx.doi.org/10.1186/s13075-023-03085-9 |
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