POS0561 OBESITY PHENOTYPES IN EARLY RHEUMATOID ARTHRITIS

Background: Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes obesity: classical obesity, metabolically healthy overweight/obesity, latent (normal associated metabolic disorders, most importantly - insulin resistance adipocytokines imbalance). Objectives: To clarify prevalence identify factors predisposing «latent obesity» in RA without diabetes mellitus or hyperglycemia. Methods: The study included 35 pts (23 women, 12 men) (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve treatment glucocorticoids disease-modifying anti-rheumatics, established mellitus. Pts were seropositive for IgM RF anti-CCP, highly active (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], CDAI 31,0 [26,0; 44,0]) scores, median disease duration 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used measure patients’ levels, ELISA (DBS – Diagnostics Biochem Canada Inc.) evaluation serum leptin concentrations. Insulin (IR) defined as Homeostasis Model Assessment Resistance index (HOMA-IR) ≥2,77. Leptin levels considered elevated at values ≥11,1 ng/ml ≥5,6 men. overweight/obesity status determined by World Health Organization criteria body mass (BMI) ≥25kg/m 2 . Results: Overweight/obesity documented 19 (54, 3%) RA, 4/19 (21%) had high IR, 11/19 (58%) isolated hyperleptinemia. Normal BMI found 16 (45,7%) 2/16 (12,5%) 6/16 (37,5%) only Four out overweight 8 (50%) did not show any disorders (p=0,02). Сlassical 15 (43%), (23%) RA. correlated waist circumference (r=0,58, p =0,02), (r=0,71, =0,0006), ESR (r=0,5, =0,02) overweight/obese pts, (r=0,59, =0,03), triglyceride (r=0,77, =0,003), atherogenic (r=0,62, =0,03) weight. Conclusion: phenotype abdominal inflammation common prevailing over other Latent less an unfavorable lipid profile accumulation fat, therefore increasing cardiovascular diseases Metabolically really rare phenotype. Disclosure Interests: None declared