Pos0769 visceral adipose tissue and adipokines/cytokines in juvenile idiopathic arthritis

Background Increased visceral adipose tissue (VAT) associates with markers for rheumatic inflammatory and cardiovascular diseases, but knowledge is sparse in juvenile idiopathic arthritis (JIA). Objectives To compare VAT mass, lipid profile and selected adipokines/cytokines in patients with JIA with matched controls, and to explore the role of VAT in disease associated inflammation and cardiovascular risk. Moreover, to explore the differences in circulating biomarkers between poly- and oligoarticular disease. Methods 60 patients with JIA (50 girls) age between 10–16 years were consecutively recruited at Oslo University Hospital and 60 age-and sex-matched controls were randomly drawn from the National Registry. The JIA group included 30 patients with persistent oligoarticular JIA (oligo disease) and 30 patients with extended oligoarticular or polyarticular disease RF +/- (poly disease). VAT (g) was estimated by dual-energy x-ray absorptiometry. Lipid profile, CRP and adipokines/cytokines (by ELISA) were analyzed. Differences between groups were tested with parametric or non-parametric analyses as appropriate and associations with univariate and multiple linear regression analyses. Results VAT (g) was comparable between patients and controls [median (25 th – 75 th percentile) 64 (23-149) vs 66 (30-99), p=0.98] and between patients with oligo disease and poly disease [46 (22-123) vs 80 (23-167), p=0.32]. Patients presented lower serum levels of APOA1 and RBP4, and elevated serum levels of IL-6, progranulin and MCP-1 (Table 1) as compared to the controls. Patients with poly disease had lower plasma levels of LDL-C, LILA, IL-1RA, progranulin and VEGF, and elevated serum levels of IL-1b and IL-1b/IL-1RA ratio (Table 1) as compared to patients with oligo disease. No statistically significant differences were seen between neither patients and controls nor patients with oligo disease and poly disease for TC, HDL-C, APOB, CRP, leptin, adiponectin, NGAL, angpl4, angiopoietin, chemerin and resistin. In patients, higher IL-6 [unstandardized B (95% CI) 48.7 (25.1, 72.2), p<0.001], resistin [8.5 (5.1, 11.8), p<0.001] and leptin [2.5 (0.9, 4.0), p=0.002] were identified as correlates for higher VAT. In controls, only higher leptin [unstandardized B (95% CI) 5.3 (3.7, 6.9), p<0.001] was identified as correlate for higher VAT. Conclusion Despite similar mass, VAT seems to be closely related to IL-6 and resistin suggesting an active metabolic role in JIA. In addition to IL-6, several pro-inflammatory adipokines/cytokines were increased in JIA potentially playing a role in disease activity. Novel biomarkes, among them IL-1b/IL-1RA system, were identified for differentiating between oligo vs poly disease. Table 1. Adipokines/cytokines in patients and controls Patients (n=60) Controls (n=60) p-value patients vs controls Oligo disease (n=29-30) Poly disease (n=30) p-value oligo vs poly disease TC (mmol/L) 3.9 (0.7) 4.2 (0.6) 0.05 4.1 (0.7) 3.8 (0.7) 0.07 LDL-C (mmol/L) 2.2 (0.6) 2.3 (0.6) 0.23 2.4 (0.5) 2.0 (0.6) 0.02 APOA1 (g/L) 1.3 (0.2) 1.4 (0.2) 0.01 1.3 (0.2) 1.3 (0.2) 0.89 LILA (nmol/L) 15 (7-37) 20 (7-74) 0.29 26 (8-79) 10 (7-22) 0.03 IL-6 (pg/mL) 0.42 (0.29-0.67) 0.34 (0.27-0.46) 0.01 0.39 (0.24-0.53) 0.48 (0.37-0.71) 0.055 IL-1b (pg/mL) 1.00 (0.84-1.14) 0.99 (0.86-1.22) 0.53 0.91 (0.75-1.01) 1.06 (0.94-1.19) 0.01 Progranulin (ng/mL) 82.3 (61.7-104.2) 69.3 (58.5-87.8) 0.03 103.2 (37.4) 72.4 (24.1) <0.001 IL-1RA (ng/mL) 0.50 (0.33-0.95) 0.62 (0.34-1.02) 0.59 0.68 (0.44-1.30) 0.39 (0.30-0.77) 0.003 RBP4 (ng/mL) 12989 (2792) 15421 (4877) 0.001 13111 (2718) 12867 (2905) 0.74 VEGF (ng/mL) 21 (15-34) 23 (15-32) 0.61 24 (17-42) 17 (13-27) 0.03 MCP-1 (ng/mL) 63.0 (54-75) 57 (46-70) 0.02 63 (55-77) 62 (54-74) 0.79 IL-1b (pg/mL)/IL-1RA (ng/mL) 1.85 (0.98-3.08) 1.76 (0.86-3.07) 0.71 1.15 (0.67-2.31) 2.83 (1.56-4.14) <0.001 Numbers are mean (SD) or median (25 th – 75 th percentile). Oligo disease persistent oligoarticular juvenile idiopathic arthritis (JIA ); poly disease extended oligoarticular JIA or polyarticular disease . REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.