Association of visceral adipose tissue with inflammation and functional impairment in women with Sjögren's disease

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OBJECTIVES: This study aimed to evaluate the association between visceral adipose tissue (VAT) levels and inflammation, disease activity, and functional impairment in women with primary Sjögren's Disease (SjD). METHODS: We included 100 female patients with SjD from a tertiary care clinic who met the ACR/EULAR 2016 classification criteria. Disease activity was assessed using the ESSDAI and ESSPRI scores, while cumulative damage was evaluated by the SSDDI. Inflammatory markers, synovitis (via ultrasound), and functional disability using the HAQ were measured. Body composition, including VAT, was analysed using dual-energy X-ray absorptiometry. Handgrip strength and physical activity (Baecke questionnaire) were also assessed. Patients were categorised into VAT tertiles, and comparisons were made to healthy controls. Correlations between VAT, disease activity, and synovitis were analysed using multiple regression models. RESULTS: The patients had a mean age of 50.5±9.3 years, BMI of 28.2±5.6 kg/m², and median disease duration of 8 years. The highest VAT tertile was associated with a higher prevalence of synovitis (75.7% vs. 51.5%; p=0.041), lower handgrip strength (p=0.025), and higher HAQ scores (p<0.001). VAT mass was significantly correlated with obesity (p<0.001), functional disability (p=0.002), and ESSPRI (p=0.01). Postmenopausal patients had significantly higher VAT levels than premenopausal patients (p=0.005). There were no significant correlations between VAT and inflammation. CONCLUSIONS: Elevated VAT levels in SjD are associated with increased disease activity, a higher prevalence of synovitis, and greater functional disability, suggesting that VAT may contribute to the functional impairment observed in SjD.

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