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LP-027 Overweight and obesity phenotypes based on body mass index and insulin resistance in women with systemic lupus erythematosus
  1. Liubov Kondrateva,
  2. Tatiana Popkova,
  3. Yulia Gorbunova,
  4. Tatiana Panafidina and
  5. Elena Gerasimova
  1. Systemic Rheumatic Disorders Department, V.A.Nasonova Research Institute of Rheumatology, Russian Federation


Background Objective: To find out the rate of various overweight phenotypes based on body mass index and insulin resistance (IR) in women with systemic lupus erythematosus (SLE).

Methods A total of 46 women with SLE (40[31;48] years old) without diabetes mellitus or hyperglycemia were enrolled in the study. The median SLE duration was 3,0[0,9;9,0] years, SLEDAI-2K was 5[2;8]. SLE pts were treated with glucocorticoids (GC) (83%), hydroxychloroquine (76%), immunosuppressive drugs (22%) and biological agents (11%). IR was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. There were three main phenotypes of obesity/overweight: 1.’classic or metabolic unhealthy obesity/overweight’ – body mass index (BMI) ≥25kg/m2 + IR, 2.’metabolically healthy obesity/overweight ‘ – BMI ≥25kg/m2 without IR, 3.’latent or metabolic unhealthy non-obesity’ – BMI <25kg/m2 + IR.

Results The classic phenotype was found in 15%, metabolically healthy phenotype – in 28%, latent phenotype – in 7%, normal weight without metabolic disturbances – in 50% women. HOMA-IR negatively correlated with SLEDAI-2K (r= -0.35, p=0.02), and positively – with waist circumference (r=0.57, p<0.0001). Patients with normal weight without metabolic disorders were younger (p=0.02), had a lower concentration of uric acid (p=0.03) than women with the classical phenotype, received lower daily dose of GC for the entire period of SLE than these with latent phenotype (p=0.05). The healthy overweight phenotype had a higher diastolic blood pressure than patients with normal weight without IR (p=0.02), and a tendency to a greater age (p=0.06).

Conclusions A combination of BMI ≥25 kg/m2 and IR was used to separate the phenotypes of obesity/overweight, since its existence did not coincide in 35% of patients with SLE. The metabolically healthy phenotype was the most frequent, the latent phenotype was the rarest. The formation of a specific phenotype seems to be influenced by age, disease activity and the intake of GC.

  • obesity phenotypes
  • body mass index
  • insulin resistance

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