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TNFα blockade for inflammatory rheumatic diseases is associated with a significant gain in android fat mass and has varying effects on adipokines: a 2-year prospective study

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Abstract

Purpose

To evaluate the long-term consequences of TNFα inhibitors on body composition and fat distribution, as well as changes in serum adipokines in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS).

Methods

Eight patients with RA and twelve with AS requiring a TNFα inhibitor were prospectively followed for 2 years. Body composition was evaluated by dual X-ray absorptiometry and included measurements of total fat mass, lean mass, fat in the gynoid and android regions, and visceral fat. Serum leptin, total and high molecular weight (HMW) adiponectin, resistin, and ghrelin were also assessed.

Results

There was a significant gain in body mass index (p = 0.05) and a tendency for weight (p = 0.07), android fat (p = 0.07), and visceral fat (p = 0.059) increase in patients with RA, while in AS, total fat mass significantly increased (p = 0.02) with a parallel weight gain (p = 0.07). When examining the whole population of patients, we observed after 2 years a significant increase in body weight (+1.9 %; p = 0.003), body mass index (+2.5 %; p = 0.004), total fat mass (+11.1 %; p = 0.007), and fat in the android region (+18.3 %; p = 0.02). There was a substantial, albeit nonsignificant gain in visceral fat (+24.3 %; p = 0.088). Lean mass and gynoid fat were not modified. No major changes were observed for serum leptin, total adiponectin, and ghrelin, while HMW adiponectin and the HMW/total adiponectin ratio tended to decrease (−15.2 %, p = 0.057 and −9.3 %, p = 0.067, respectively). Resistin decreased significantly (−22.4 %, p = 0.01).

Conclusions

Long-term TNFα inhibition in RA and AS is associated with a significant gain in fat mass, with a shift to the android (visceral) region. This fat redistribution raises questions about its influence on the cardiovascular profile of patients receiving these treatments.

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Acknowledgments

The authors are indebted to Nhu Uyen Nguyen MD, PhD, Department of Physiology, University Hospital of Besançon, France, for participating in the study design and to Mrs Fiona Ecarnot, MSc, EA3920, Department of Cardiology, University Hospital Besançon, France, for her help in preparing the manuscript. We would like to thank the following financial supports: the Association Franc Comtoise pour la recherché et l’Enseignement en Rhumatologie, the Agence Nationale de la Recherche (Labex LipSTIC, ANR-11-LABX-0021), and the Conseil Régional de Franche-Comté (“soutien au LabEX LipSTiC” 2012, for Lunar CoreScan software).

Conflict of interest

The authors have no conflict of interest to declare.

Author information

Authors and Affiliations

  1. Clinical Investigation Center for Biotherapy (INSERM CBT-506), University Hospital of Besançon, Bâtiment St Joseph, 2 Place St Jacques, 25000, Besançon, France

    Éric Toussirot

  2. INCREASE, FHU, Besançon, France

    Éric Toussirot

  3. Department of Rheumatology, University Hospital of Besançon, Besançon, France

    Éric Toussirot & Daniel Wendling

  4. Department of Therapeutics, University of Franche Comté, Besançon, France

    Éric Toussirot

  5. UPRES EA 4266, Pathogens and Inflammation, SFR FED 4234, University of Franche Comté, Besançon, France

    Éric Toussirot & Daniel Wendling

  6. LabEX LipSTIC, ANR-11-LABX-0021, 25020, Besançon Cedex, France

    Éric Toussirot

  7. University Hospital of Besançon, Besançon, France

    Laurent Mourot

  8. EA 4660 Culture Sport Health Society and Exercise Performance, Health, Innovation Platform, University of Franche Comté, 25000, Besançon, France

    Laurent Mourot

  9. Clinical Investigation Center for Innovative Technologies (INSERM CIT-808), University Hospital of Besançon, Place St Jacques, 25000, Besançon, France

    Laurent Mourot

  10. Endocrine and Metabolic Biochemistry, University Hospital of Besançon, 25000, Besançon, France

    Barbara Dehecq, Émilie Grandclément & Gilles Dumoulin

  11. UPRES EA 3920 Cardiovascular Pathophysiology and Prevention, SFR FED 4234, University of Franche Comté, Besançon, France

    Gilles Dumoulin

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  1. Éric Toussirot
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on behalf of CBT-506

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Correspondence to Éric Toussirot.

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The study was conducted on behalf of CBT-506.

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Toussirot, É., Mourot, L., Dehecq, B. et al. TNFα blockade for inflammatory rheumatic diseases is associated with a significant gain in android fat mass and has varying effects on adipokines: a 2-year prospective study. Eur J Nutr 53, 951–961 (2014). https://doi.org/10.1007/s00394-013-0599-2

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  • DOI: https://doi.org/10.1007/s00394-013-0599-2

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