BACKGROUND:The introduction of glucagon-like peptide 1 receptor agonists (GLP-1RAs) has provided new avenues for managing type 2 diabetes (T2D), aiming to achieve optimal glycaemic control while minimising treatment burden. We conducted a multicentre retrospective real-world study to assess the effectiveness of semaglutide once-weekly (OW) in patients previously treated with insulin. METHODS:We included individuals with T2D who were on insulin (basal and/or bolus) and initiated OW semaglutide at 18 specialist care centres. We collected retrospective data on baseline clinical characteristics and updated values of HbA1c and body weight. The primary outcome was the change in HbA1c analysed using the mixed model for repeated measures. Secondary outcomes included the changes in body weight, insulin discontinuation and the change in insulin doses. RESULTS:The study included 674 individuals. At baseline, participants were 61.7 years old, with a mean diabetes duration of 11.5 years and an HbA1c of 8.2%. During a median follow-up of 18 months, OW semaglutide initiation led to a significant reduction in HbA1c (-0.9%) and body weight (-4.3 kg), with 60% of patients achieving HbA1c < 7%. 32.8% of patients discontinued insulin therapy, 72.5% of whom achieved an HbA1c < 7%. Among patients on basal-bolus insulin, 75% completely discontinued bolus, 62% of whom achieved an HbA1c < 7%. Predictors of insulin discontinuation included shorter diabetes duration, lower baseline HbA1c, and lower insulin doses. Among patients who remained on insulin, initiation of OW semaglutide was associated with a decrease in total daily insulin requirement. CONCLUSION:Our study highlights OW semaglutide as a valuable addition to a T2D regimen based on insulin, offering effective glycaemic and weight control with the potential for insulin deintensification or discontinuation.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in type 2 diabetes (T2D) management for their glycemic and weight benefits. However, their appetite-suppressing effects may influence dietary intake and nutrient adequacy, yet real-world evidence is scarce. Objective: To evaluate dietary intake and adherence to the Mediterranean diet in adults with T2D treated with GLP-1RAs compared to those receiving other oral hypoglycemic agents. Methods: In this cross-sectional study, 103 adults with T2D (mean age 66 ± 8 years; 65% male) attending a diabetes clinic in Turin, Italy, were enrolled between February and June 2025. Dietary habits were assessed using a validated food frequency questionnaire, and adherence to the Mediterranean diet was evaluated via the Mediterranean Diet Score (MDS). Anthropometric, biochemical, and lifestyle data were collected. Results: Fifty-two participants (50.5%) were treated with GLP-1RAs (semaglutide 55.8%, dulaglutide 40.4%). No significant differences in energy intake, macronutrient distribution, or MDS were observed between groups. Overall, diets were characterized by low carbohydrate intake (~44% of energy), inadequate fiber (≈11 g/1000 kcal), and high fat intake (≈39–40% of energy), with saturated fat below 10%. None of the GLP-1RA users met fiber recommendations. Subgroup analysis by treatment duration (<1 year, 1–2 years, >2 years) revealed no significant differences in dietary patterns. Conclusions: Patients with T2D, regardless of pharmacological treatment, exhibited poor adherence to dietary guidelines. These findings highlight the need for structured nutritional counseling alongside GLP-1RA therapy to optimize metabolic outcomes and prevent nutritional deficiencies.

Introduction:Cognitive impairment is a frequent complication of type 2 diabetes (T2DM). Global longitudinal strain (GLS), an echocardiographic marker of subclinical left ventricular (LV) systolic dysfunction, has been associated with adverse cardiovascular outcomes in T2DM. However, its relationship with cognitive performance remains unexplored. The aim was to investigate the association between GLS and cognitive function in patients with T2DM. Methods:We prospectively enrolled 234 T2DM patients without hemodynamically significant carotid stenosis, history of stroke or severe hypoglycemia. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and GLS measured via speckle-tracking echocardiography. Multivariable linear regression models were used to evaluate associations between GLS and RBANS scores. Sensitivity analyses excluded individuals with coronary heart disease (CHD), atrial fibrillation (AF), or LV ejection fraction (LVEF) <50%. Results:The mean RBANS total score was 96.7 ± 17.1; 19.7% of participants scored <80, indicating borderline/impaired cognition. Mean GLS was -19.23 ± 2.59%, with 29.1% of patients showing subclinical LV dysfunction (GLS ≥ -18%). Unlike LVEF, impaired GLS (≥ -18%) was associated with lower RBANS total scores. This association remained significant after excluding individuals with CHD, AF, or LVEF<50%, and after adjusting for age, sex, education, lifestyle factors, metabolic and hemodynamic parameters. Educational attainment modified the association, with stronger GLS-cognition links in participants with lower education. The relationship was unaffected by adjustment for markers of inflammation and endothelial dysfunction. Conclusions:In patients with T2DM, impaired GLS is independently associated with reduced cognitive performance, even in patients with normal LVEF.

AIM:Left ventricular hypertrophy (LVH) is highly prevalent among individuals with type 2 diabetes (T2DM) and is a predictor of adverse cardiovascular outcomes. Visceral and ectopic fat accumulation contributes to cardiometabolic risk. Neck circumference (NC) and the neck circumference-to-height index (NCI) have emerged as potential markers of ectopic adiposity, yet their association with LVH remains unexplored. The aim of this study was to evaluate the relationship between NC and NCI with the presence of LVH in a contemporary cohort of T2DM patients. MATERIALS AND METHODS:T2DM patients were consecutively enroled in the TESEO study. Participants underwent comprehensive clinical, biochemical, bioimpedance and echocardiographic evaluations. Multivariable logistic regression models were used to examine the independent associations between NC/NCI and LVH, adjusting for age, sex, mean arterial blood pressure, HbA1c, triglycerides, estimated glomerular filtration rate, urinary albumin-to-creatinine ratio and treatments. RESULTS:29% of participants had LVH. NC and NCI were higher among individuals with LVH. After full adjustment, NC and NCI were independently associated with 26% and 57% higher odds of LVH, respectively. Stratified analyses revealed a stronger association in men (OR 1.65, 95% CI: 1.25-2.18) than in women (OR 1.49, 95% CI: 1.19-1.87). NC and NCI outperformed BMI and waist circumference in their association with LVH. ROC curve analyses confirmed that NCI has good discriminatory power for identifying individuals with and without LVH. CONCLUSIONS:NC and NCI are independently associated with LVH in T2DM patients and they may represent practical, non-invasive markers to enhance cardiovascular risk stratification in clinical settings.

BACKGROUND:Global longitudinal strain (GLS) of the left ventricular is a highly sensitive and reliable marker of systolic function and GLS outperforms ejection fraction (EF) in detecting preclinical left ventricular systolic dysfunction (LVSD). In patients with type 2 diabetes (DM2) albuminuria is a predictor of symptomatic heart failure, but data on the relationship between GLS and albuminuria are conflicting. AIM:To explore the relationship between GLS and albuminuria in a contemporary cohort of DM2 patients. METHODS:The study was performed on DM2 patients consecutively enrolled in the TESEO study. Patients with symptoms/signs of heart failure, EF < 50%, coronary artery, other cardiac diseases, or non-adequate acoustic window for GLS assessment were excluded. We collected clinical data, screened for complications, and measured GLS by speckle-tracking echocardiography. Univariate and multiple linear regression analyses were performed to identify independent explanatory variables associated with GLS. Logistic regression analysis was used to assess whether albuminuria was independently associated with GLS-diagnosed (GLS > -18%) LVSD. RESULTS:Patients (n = 193, age: 60.6 ± 8.1, male: 57%) had a short DM2 duration (3.8 ± 4.9 years) and good metabolic control (glycated haemoglobin A1c: 6.5% ± 1.0). Preclinical GLS-LVSD was present in 21.8% of the patients. GLS values were significantly higher in patients with albuminuria (-19.88 ± 2.16 vs -18.29 ± 2.99, P < 0.001) and in multivariate analysis natural logarithm of albumin-creatinine ratio and uric acid were independent predictors of GLS. In logistic regression analysis, albuminuria was associated with a 6.01 (95% confidence interval: 1.874-19.286) increased odds ratio of GLS-LVSD, independent of age, sex, diastolic blood pressure, chronic kidney disease, EF, mitral annulus velocity lateral, uric acid, and treatments. CONCLUSION:Albuminuria was independently associated with subclinical LVSD in our contemporary cohort of DM2 patients.

Sulfonylureas constitute the standard therapy for patients with HNF1A-MODY (maturity-onset diabetes of the young) but are characterized by an increased risk of hypoglycemia. While SGLT2 inhibitors (SGLT2i) may potentially represent a useful therapeutic option, data from the literature are scant. We report the case of a young woman affected by HNF1A-MODY who was successfully and safely treated with an SGLT2i in addition to sulfonylurea. After SGLT2i initiation, an improvement in the patient’s glycemic control was observed and was maintained over time. No adverse effects were noted and, in particular, no increase in ketonemia or ketonuria occurred. The use of SGLT2i under controlled circumstances may represent a useful therapeutic option in patients with HNF1A-MODY.

AIMS:Chronic kidney disease (CKD) is a prevalent and serious complication of type 2 diabetes (T2D). This study aims to evaluate kidney outcomes in a real-world cohort of patients with T2D and CKD who received SGLT2 inhibitors (SGLT2i) or other glucose-lowering medications (GLM). MATERIALS AND METHODS:This retrospective, multicentre study analysed data from patients aged 18-80 years with T2D and CKD, who initiated an SGLT2i or other GLM between 2015 and 2020. The primary outcome was the change in estimated glomerular filtration rate (eGFR) over time. Secondary outcomes included albuminuria changes and adverse kidney events. Propensity score matching was used to balance baseline characteristics between the two groups. RESULTS:After matching (n = 2020/group), patients (100% T2D with CKD) had a mean age of 63 years, BMI 32 kg/m2, HbA1c 8.2%. New-users of SGLT2i exhibited a slower decline in eGFR compared with new users of comparators (mean difference 1.43 mL/min/1.73 m2; p = 0.048). Albuminuria improved significantly more in the SGLT2i group, with a greater likelihood of category improvement (hazard ratio [HR] 1.17; p = 0.007). SGLT2i initiation was associated with a lower incidence of kidney outcomes, including a ≥40% eGFR reduction (HR 0.63; p = 0.004). When the comparison was restricted to SGLT2i versus GLP-1RA (n = 1266/group), the eGFR slope was significantly better with SGLT2i (mean difference 0.62 mL/min/1.73 m2/year; p = 0.046). CONCLUSIONS:In this large, real-world cohort, initiation of SGLT2i was associated with a significantly slower decline in kidney function and improved albuminuria compared with other diabetes drugs, including GLP-1RA. These findings support SGLT2i as the most effective T2D treatment to slow CKD progression.

IntroductionMetabolic dysfunction–associated steatotic liver disease (MASLD) is highly prevalent among individuals with type 2 diabetes mellitus (T2DM), and liver fibrosis represents its strongest predictor of adverse outcomes. Soft drinks (SDs), a major source of added sugars and fructose, have been linked to metabolic disorders, but evidence on their relationship with liver fibrosis in patients with T2DM is limited. This study investigated the association between SDs consumption and liver fibrosis in adults with both T2DM and liver steatosis.MethodsWe analyzed 273 participants from the TESEO-DM cohort with imaging-documented hepatic steatosis (Controlled Attenuation Parameter, CAP ≥248 dB/m). SDs intake was assessed using the validated EPIC food frequency questionnaire and categorized as rarely/never, 1–4 servings per month, or >1 servings per week. Liver stiffness measurement (LSM) was assessed using vibration-controlled transient elastography and LSM >7 used as cut-off to define significant liver fibrosis.ResultsIn age- and sex-adjusted linear regression, SDs intake was directly associated with LSM (β = 0.181, 95% CI: 0.062–0.299, p = 0.003). The association remained significant after adjustment for diabetes duration, total caloric intake, high-density lipoprotein cholesterol, and either body mass index (β = 0.153, 95% CI: 0.032–0.274, p = 0.014) or CAP (β = 0.150; 95% CI: 0.028–0.274; p = 0.017). In logistic regression, participants consuming >1 SDs per week had increased odds of significant liver fibrosis (OR: 3.77, 95% CI: 1.33–10.66) compared with those rarely or never consuming SDs independent of age, sex, diabetes duration, and obesity. Inclusion into the model of tertiles of CAP in place of obesity did not modify the results (OR: 3.11 95% CI: 1.09–8.86).ConclusionsThese findings suggest that even modest soft drink consumption is independently associated with higher liver stiffness in individuals with T2DM and liver steatosis, supporting recommendations to limit added sugar intake for liver health.

Background:Remission of type 2 diabetes (T2D) is becoming feasible with modern treatments, including GLP-1 receptor agonists (GLP-1RA). Here, we explored frequency, characteristics, and outcomes associated with various definitions of remission after initiation of GLP-1RA. Methods:This was an observational study on new-users of GLP-1RA. We explored 4 definitions of remission: (1) HbA1c to <6.5% persisting ≥3 months in the absence of diabetes pharmacotherapy; (2) As in 1, but allowing GLP-1RA therapy; (3) As in 1, but without new diabetes pharmacotherapy; (4) As in 1, but irrespectively of ongoing diabetes pharmacotherapy. Findings:We included 14,141 participants initiating GLP-1RA (60% men, 60-year-old, with a diabetes duration of ∼10 years, BMI 32 kg/m2, HbA1c 8.1%). The mean observation was 4 years. Remission frequencies by definition were: (1) 5.8%; (2) 6.2%; (3) 12.2%; (4) 18.3%. Duration was shorter for remission 1-2 (5-6 months) than for remission 3-4 (9-10 months). Factors associated with remission were similar across definitions (shorter diabetes duration, higher BMI, lower burden of complications and medications). Remission was associated with significant and sustained benefits on HbA1c (-1%) and body weight (-2 kg). Microvascular events were reduced by 12-16% in participants with remission 1, 2 or 3. Cardiovascular events were reduced only in remission 3 (HR 0.65; 95% C.I. 0.48-0.88). Interpretation:T2D remission is not rare after initiation GLP-1RA, its frequency and duration varying by definition. When achieved, remission is associated with durable metabolic improvements up to 4 years and fewer incident complications. Funding:Supported by the Italian Diabetes Society (Società Italiana di Diabetologia).

Background/Objectives: The characterization of patients with inflammatory bowel disease (IBD) and type 2 diabetes mellitus (T2DM) as a new group has not been well detailed. This study aimed to evaluate the impact of T2DM on IBD progression and analyze the prevalence of steatotic liver disease and liver damage in these patients. Methods: Through a retrospective case-control study, we compared severe IBD occurrence in patients with both IBD-T2DM (cases) versus those with IBD alone (controls). Among 1047 medical records, 79 IBD-T2DM patients were selected and compared to 308 controls in a 1:4 ratio. Severe IBD was defined by variables such as surgery, target therapy, corticosteroid use, and hospitalization. Liver damage was assessed using Fib-4 (>1.3), and hepatic steatosis was evaluated by imaging. Results: There was no significant difference in severe disease rates (59.5% vs. 59.7%; p = 0.97). IBD-T2DM patients had higher rates of hepatic steatosis (62.9% vs. 27.2%; p < 0.0001) and liver damage (55.4% vs. 26.6%; p < 0.0001). IBD-T2DM patients used more corticosteroids (p < 0.0001) and fewer anti-TNF-alpha drugs (p = 0.007). The median age at diagnosis was higher in IBD-T2DM patients (48 vs. 32; p < 0.0001). In Crohn's disease, 24.3% of IBD-T2DM patients had exclusive colonic involvement compared to 5% in the IBD-only group (p = 0.003). Conclusions: T2DM was not associated with worse IBD progression, but was linked to increased liver steatosis and damage. Differences such as age of onset, colonic involvement, and liver damage suggest that IBD-T2DM patients could configure a special population worthy of further studies.

Aim Oral semaglutide, an innovative orally administered GLP-1 receptor agonist for type 2 diabetes (T2D) management was herein evaluated for its effectiveness in a multi-center retrospective real-world study. Methods We included new-users of oral semaglutide from 18 specialist care centres and collected retrospective data on baseline clinical characteristics. Updated values of HbA1c and body weight were analyzed using the mixed model for repeated measures. Results The study included 166 individuals with T2D, predominantly men (64.5%), with a mean age of 64.4 years and a mean diabetes duration of 10.1 years. In the majority of patients (68.3%) oral semaglutide was used as a second-line drug, mostly with metformin. At baseline, mean BMI was 28.9 kg/m 2 and HbA1c was 7.5%. During the 18-month observation period, oral semaglutide demonstrated significant reductions in HbA1c, with a maximum change of − 0.9%, and 42.1% of patients achieved HbA1c values below 7.0%. Additionally, there was a substantial reduction in body weight, with an estimated change of − 3.4 kg at 18 months, and 30.3% of patients experienced a 5% or greater reduction in baseline body weight. Only 24.2% of patients reached the 14 mg dose. Subgroup analysis revealed that baseline HbA1c > 7%, persistence on drug, not being on a prior therapy with DPP-4 inhibitors, and loosing 5% or more the initial body weight were associated with greater HbA1c reductions. Conclusion This study supports oral semaglutide as an effective option for T2D treatment, offering improved glucose control and weight management in a real-world setting.

To compare diabetic retinopathy screening among patients with type 1 or type 2 diabetes under care in two distinct setups: hospital-based multidisciplinary and general practice-based. In this retrospective observational case series, we collected data from a total of 133 diabetic patients: subjects from the hospital-based multidisciplinary setting were referred by the diabetologist and screened by an ophthalmologist using the Optomed Aurora IQ fundus camera. These patients were compared with those who underwent DR screening arranged through a general practice-based setting. The proportion of patients treated with insulin was higher in the hospital-based multidisciplinary group, both considering the totality patients and those affected by type 2 diabetes (71.6

This commentary aims to offer a perspective on the effect of tirzepatide on hypoxic burden and provide indirect evidence of cardiovascular risk reduction after tirzepatide for the treatment of obstructive sleep apnea and obesity. It also discusses the role of tirzepatide-induced weight loss in the management of obstructive sleep apnea. Recent Findings. In the SURMOUNT-OSA phase 3 trials, tirzepatide, a new GIP/GLP-1 receptor co-agonist, reduced the apnea–hypopnea index, hypoxic burden, and body weight in adults with moderate-to-severe obstructive sleep apnea and obesity. The change in apnea–hypopnea index is clinically relevant, but its impact on cardiovascular mortality remains unclear. Conversely, hypoxic burden predicts cardiovascular mortality across populations independent of AHI. We attempted to postulate the magnitude of cardiovascular benefits of tirzepatide based on the reduction in hypoxic burden. Tirzepatide treatment for obstructive sleep apnea and obesity seems to result in hypoxic burden values associated with a lower cardiovascular mortality rate and thus might attenuate the negative cardiovascular impact of hypoxic burden.

Objective: To assess the complementary role of the Body Mass Index (BMI) and Edmonton Obesity Staging System (EOSS) in predicting all-cause and cause-specific mortality in people living with overweight and obesity (PLwOW/O). Methods: A longitudinal analysis of prospectively collected data from the 1999-2018 cycles of the National Health and Nutrition Examination Survey (NHANES) was conducted. The association between BMI, EOSS, and mortality was evaluated through Cox regression models, adjusted for confounders. Results: The analysis included 36,529 subjects; 5329 deaths occurred over a median follow-up of 9.1 years (range: 0-20.8). An increased mortality risk was observed for obesity class II and III (HR = 1.21, 95% CI 1.08-1.36, p = 0.001 and HR = 1.58, 95% CI 1.39-1.80, p < 0.001; compared to overweight), and for EOSS stage 2 and 3 (HR = 1.36, 95% CI 1.16-1.58, p < 0.001 and HR = 2.66, 95% CI 2.26-3.14, p < 0.001; compared to stage 0/1). The prognostic role of BMI was more pronounced in younger patients, males, and non-Black individuals, while that of EOSS was stronger in women. Both BMI and EOSS independently predicted cardiovascular- and diabetes-related mortality. EOSS stage 3 was the only predictor of death from malignancy or renal causes. Conclusions: BMI and EOSS independently predict all-cause and cause-specific mortality in PLwOW/O. Their integrated use seems advisable to best define the obesity-related mortality risk.

The incidence of diabetes mellitus is dramatically increasing worldwide, and diabetic nephropathy now represents the cause of 48% of newly diagnosed cases of end-stage renal disease in the US and approximately 20% of new entrances on dialysis in Italy.1

Abstract Background GLP-1 RA are antidiabetic drugs approved for treatment of TDM2 as second-choice therapy for long-term treatment in patients with TMD2 without previous cardiovascular events or as first-choice therapy in patients with previous cardiovascular events and without heart failure (SID/AMD guidelines). Their beneficial effect is not only associated with glycol-metabolic control, but also with a systemic anti-inflammatory action. In view of this anti-inflammatory action, we wanted to assess whether GLP1-RA could have a possible beneficial effect on IBD in terms of laboratory and clinical parameters. Moreover, these drugs have proven to improve liver function and histology, therefore, liver wellbeing may also be included as a cross-sectional element of evaluation in the possible benefits of these therapies. Methods Through the evaluation of 981 medical records of IBD patients followed in the gastroenterology department of the Hospital San Giovanni Antica Sede (SGAS), 71 TDM2 patients were identified. Among these, 21 were recruited for the study. The recruited patients were scheduled for a diabetological examination: GLP-1 RA treatment could then be introduced where indicated. At a 3-month follow-up interval, both the GLP-1 RA treatment group and the subjects that did not have any changes in therapy (control group) underwent re-evaluation of the parameters of interest. All patients in the study were offered the possibility to receive a FibroScan to measure liver stiffness at the start of the study and at the 3-months follow-up. Results A prevalence in the IBD population of TDM2 was found to be 7.2% (vs. Piedmont population prevalence 6.2%, p = 0.31). Out of the 21 patients recruited, 6 received GLP-1 RA treatment. At 3 months, an analysis of the results through the Wilcoxon test showed that the GLP-1 RA treated patients had a reduction in faecal calprotectin levels, an improvement in disease scores, an improvement in glycemic balance and a reduction in CAP and FIB4 when compared to the control group; these results did not reach statistical significance. In contrast, the reduction in BMI reached statistical significance. A comparison of the deltas for the variables under analysis between the two groups was also carried out using the Mann-Whitney test. Concordant and positive trends were observed in the GLP-1 RA-treated group: in this case the reduction in HbA1c reached statistical significance. Conclusion Treatment with GLP-1 RA in patients with TDM2 and IBD appears safe and seems to show benefits from an intestinal, metabolic and hepatic viewpoint. Studies with a larger number of subjects are certainly needed to effectively confirm the benefit of GLP-1 RA in this specific category of patients.

Background Rheumatoid Arthritis (RA) is associated with increased cardiovascular (CV) morbidity and mortality and osteometabolic alterations risk, associated with chronic inflammation, the use of glucocorticoids (GC) and the reduced physical exercise.[1] Objectives The objective of the study is to cross-sectionally estimate cardiovascular risk and osteometabolic status in patients (pts) with RA and to evaluate the association with some disease parameters such as positivity of autoantibodies, disease activity and steroid therapy. Methods At the current time, 61 consecutive pts with diagnosis of RA, admitted to the Rheumatology Unit of the University Hospital of Turin, were prospectively recruited and assessed for cardiometabolic risk by the Endocrinology Unit, by undergoing laboratory and instrumental tests. Results The following prevalences were observed: arterial hypertension (52%), type 2 diabetes mellitus (7%), dyslipidemia (56%), osteoporosis (42%), and vertebral fracture (30%). At the univariate analysis, the enrolled pts were divided according to serodiagnosis, GC therapy and disease remission. No statistically significant results were highlighted stratifying population by serodiagnosis. Pts with high disease activity showed lower bone mineral density (BMD) values [BMD femoral trochanter: 0.53± 0.08 vs 0.60 ± 0.08 (g/m2), p=0.031] and T-score value on bone densitometry [T-score Femoral total: -1.88 ± 0.53 vs -1.07 ± 0.83, p=0.005], higher percentage of osteoporosis [67% vs 27%, p=0.047] and vertebral fractures [60% vs 12%, p=0.001], and higher sarcopenia score [SARC-F: 5 (3-7) vs 2 (2-4), p=0.020], in comparison with pts with remission disease. These differences were not confirmed when the population was divided according to the use of GC therapy. For CV risk factors, disease activity group showed a trend of higher prevalence compared to remission group, but without reaching statistical significance. At the multivariate analysis, advanced age (p=0.001), GC therapy (p=0.021) and copeptin (p=0.002) showed an inverse association and lumbar T-score (p=0.002) a direct one with lumbar trabecular bone score (TBS). Moreover, male gender (p=0.001) revealed a direct and significant association, while copeptin (p=0.086) an inverse and not significant one with percentage of lean mass on total densitometry, correcting for advanced age, duration of disease, GC therapy, and disease activity. In the last model, advanced age (p<0.001) and copeptin (p<0.001) showed a direct and significant association with HeartSCORE, correcting for parameters of disease while serodiagnosis, duration of disease, GC therapy, and disease activity. Conclusion At univariate analysis osteometabolic alterations were associated with disease activity, but not with GC therapy and serodiagnosis. At the multivariate analysis, the association of disease activity and TBS values, did not reach the statistical significance, probably for the loss of statistical power. However, GC therapy, as well as advanced age, low lumbar T-score and high value of copeptin, remained independently associated with lower TBS value. Disease parameters were not associated with lower percentage of lean mass at total body densitometry and higher HeartSCORE values, while advanced age and copeptin were associated with bone health and cardiovascular risk. Reference [1] Mackey RH et al. Rheum Dis Clin North Am 2018. Acknowledgements: NIL. Disclosure of Interests None Declared.Table 1Multivariate linear regression analysisCovariates associated with lumbar TBSB-coefficientCI 95%p-valueAge-0.005(-0.007- -0.002)0.001GC-0.068(-0.125- -0.011)0.021T-Score0.049(0.020-0.079)0.002Copeptin-0.014(-0.023- -0.006)0.002Covariates associated with HeartSCORE cardiovascular risk scoreB-coefficientCI 95%p-valueAge0.242(0.180-0.304)<0.001Duration of disease-0.045(-0.099-0.008)0.096RF and/or ACPA +-0.224(-1.855-1.407)0.782GC0.840(-0.454-2.135)0.195Copeptin0.345(0.172-0.518)<0.001Remission0.502(-0.848-1.853)0.454