AB1496 MICROCIRCULATION CHARACTERIZATION IN ANOREXIA NERVOSA PATIENTS WITH RAYNAUD’S PHENOMENON
Background:Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Limited data on a possible association with microcirculation damage in this context are published.Objec...
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| Vydáno v: | Annals of the rheumatic diseases Ročník 83; číslo Suppl 1; s. 2117 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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Kidlington
BMJ Publishing Group Ltd and European League Against Rheumatism
01.06.2024
Elsevier B.V Elsevier Limited |
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| ISSN: | 0003-4967, 1468-2060 |
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| Abstract | Background:Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Limited data on a possible association with microcirculation damage in this context are published.Objectives:To characterize the microcirculation characteristics of anorexia nervosa patients through nailfold video capillaroscopy (NVC).Methods:Consecutive female patients with AN undergoing NVC due to RP and no known rheumatic disease were recruited. Controls (HC) were recruited among female subjects with a body mass index (BMI) >20 kg/m2 undergoing screening NVC due to RP and no concomitant rheumatic disease (primary RP). NVC was performed in each patient (digits II to V bilaterally). Two images taken at the center of each nailfold were evaluated by a single examiner to assess the presence of the following major microcirculation features: giant capillaries (defined by a diffuse >50 micrometers enlargement of a capillary loop), neoangiogenesis (bushy or deranged vessels), empty dermal papillae, hemosiderin deposits (dark deposits above capillaries suggestive of microhemorrages), microthromboses (cap-like hemosiderin deposits). Minimum and mean capillary density was registered. NEMO score was calculated as the cumulative number of hemosiderin deposits in all the examined digits. ANA (anti-nuclear antibodies) and ENA (anti extractible nuclear antigen antibodies) determination was available for all the recruited subjects. The following laboratory values related to nutritional status were collected for AN patients: hemoglobin, platelets, glucose, triglycerides, albumin, total serum proteins, urate, total, HDL and LDL cholesterol, folate, vitamin D, vitamin B12, prolactin, FSH, LH, complement C3 and C4. Weight and height were measured to calculate BMI.Results:Forty-seven AN patients with a mean age 25.5 ± 9.1 years and all with a BMI lower than 18.5 kg/m2, and 17 HC with a mean age 33.2 ± 10.5 years of were recruited. All the recruited subjects were negative for ANA and ENA. Compared to healthy controls, AN patients showed a significantly higher frequency of any of the considered capillaroscopic alterations (p=0.007) and in particular of empty dermal papillae (p=0.04). Among the considered laboratory values, HDL cholesterol level inversely correlated (point-biserial coefficient) with the presence of empty dermal papillae (p=0.032, R2=-0.476) and directly correlated (Pearson) with the mean capillary density (p=0.030, R2=0.396).Conclusion:We described the presence of microcirculation alterations in patients with anorexia nervosa without concomitant rheumatic diseases or autoantibody positivity. Microcirculation alterations and in particular the presence of empty dermal papillae, resembling a connective tissue disease NVC specific pattern, suggest the presence of a microcirculation damage in more than 30% of AN patients with RP. Among nutritional markers, HDL cholesterol, classically considered a protective cardiovascular factor, seems to correlate inversely with the microcirculation damage detected. This observation might provide a clue to investigate from a mechanistic point of view the relationship between AN, RP, and microcirculation damage.REFERENCES: NIL.Table 1.Figure 1.Capillaroscopy of a 22 years old female with anorexia nervosa and Raynaud’s phenomenon.Acknowledgements:NIL.Disclosure of Interests:None declared. |
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| AbstractList | Background:Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Limited data on a possible association with microcirculation damage in this context are published.Objectives:To characterize the microcirculation characteristics of anorexia nervosa patients through nailfold video capillaroscopy (NVC).Methods:Consecutive female patients with AN undergoing NVC due to RP and no known rheumatic disease were recruited. Controls (HC) were recruited among female subjects with a body mass index (BMI) >20 kg/m2 undergoing screening NVC due to RP and no concomitant rheumatic disease (primary RP). NVC was performed in each patient (digits II to V bilaterally). Two images taken at the center of each nailfold were evaluated by a single examiner to assess the presence of the following major microcirculation features: giant capillaries (defined by a diffuse >50 micrometers enlargement of a capillary loop), neoangiogenesis (bushy or deranged vessels), empty dermal papillae, hemosiderin deposits (dark deposits above capillaries suggestive of microhemorrages), microthromboses (cap-like hemosiderin deposits). Minimum and mean capillary density was registered. NEMO score was calculated as the cumulative number of hemosiderin deposits in all the examined digits. ANA (anti-nuclear antibodies) and ENA (anti extractible nuclear antigen antibodies) determination was available for all the recruited subjects. The following laboratory values related to nutritional status were collected for AN patients: hemoglobin, platelets, glucose, triglycerides, albumin, total serum proteins, urate, total, HDL and LDL cholesterol, folate, vitamin D, vitamin B12, prolactin, FSH, LH, complement C3 and C4. Weight and height were measured to calculate BMI.Results:Forty-seven AN patients with a mean age 25.5 ± 9.1 years and all with a BMI lower than 18.5 kg/m2, and 17 HC with a mean age 33.2 ± 10.5 years of were recruited. All the recruited subjects were negative for ANA and ENA. Compared to healthy controls, AN patients showed a significantly higher frequency of any of the considered capillaroscopic alterations (p=0.007) and in particular of empty dermal papillae (p=0.04). Among the considered laboratory values, HDL cholesterol level inversely correlated (point-biserial coefficient) with the presence of empty dermal papillae (p=0.032, R2=-0.476) and directly correlated (Pearson) with the mean capillary density (p=0.030, R2=0.396).Conclusion:We described the presence of microcirculation alterations in patients with anorexia nervosa without concomitant rheumatic diseases or autoantibody positivity. Microcirculation alterations and in particular the presence of empty dermal papillae, resembling a connective tissue disease NVC specific pattern, suggest the presence of a microcirculation damage in more than 30% of AN patients with RP. Among nutritional markers, HDL cholesterol, classically considered a protective cardiovascular factor, seems to correlate inversely with the microcirculation damage detected. This observation might provide a clue to investigate from a mechanistic point of view the relationship between AN, RP, and microcirculation damage.REFERENCES: NIL.Table 1.Figure 1.Capillaroscopy of a 22 years old female with anorexia nervosa and Raynaud’s phenomenon.[Figure omitted. See PDF]Acknowledgements:NIL.Disclosure of Interests:None declared. Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Limited data on a possible association with microcirculation damage in this context are published. To characterize the microcirculation characteristics of anorexia nervosa patients through nailfold video capillaroscopy (NVC). Consecutive female patients with AN undergoing NVC due to RP and no known rheumatic disease were recruited. Controls (HC) were recruited among female subjects with a body mass index (BMI) >20 kg/m2 undergoing screening NVC due to RP and no concomitant rheumatic disease (primary RP). NVC was performed in each patient (digits II to V bilaterally). Two images taken at the center of each nailfold were evaluated by a single examiner to assess the presence of the following major microcirculation features: giant capillaries (defined by a diffuse >50 micrometers enlargement of a capillary loop), neoangiogenesis (bushy or deranged vessels), empty dermal papillae, hemosiderin deposits (dark deposits above capillaries suggestive of microhemorrages), microthromboses (cap-like hemosiderin deposits). Minimum and mean capillary density was registered. NEMO score was calculated as the cumulative number of hemosiderin deposits in all the examined digits. ANA (anti-nuclear antibodies) and ENA (anti extractible nuclear antigen antibodies) determination was available for all the recruited subjects. The following laboratory values related to nutritional status were collected for AN patients: hemoglobin, platelets, glucose, triglycerides, albumin, total serum proteins, urate, total, HDL and LDL cholesterol, folate, vitamin D, vitamin B12, prolactin, FSH, LH, complement C3 and C4. Weight and height were measured to calculate BMI. Forty-seven AN patients with a mean age 25.5 ± 9.1 years and all with a BMI lower than 18.5 kg/m2, and 17 HC with a mean age 33.2 ± 10.5 years of were recruited. All the recruited subjects were negative for ANA and ENA. Compared to healthy controls, AN patients showed a significantly higher frequency of any of the considered capillaroscopic alterations (p=0.007) and in particular of empty dermal papillae (p=0.04). Among the considered laboratory values, HDL cholesterol level inversely correlated (point-biserial coefficient) with the presence of empty dermal papillae (p=0.032, R2=-0.476) and directly correlated (Pearson) with the mean capillary density (p=0.030, R2=0.396). We described the presence of microcirculation alterations in patients with anorexia nervosa without concomitant rheumatic diseases or autoantibody positivity. Microcirculation alterations and in particular the presence of empty dermal papillae, resembling a connective tissue disease NVC specific pattern, suggest the presence of a microcirculation damage in more than 30% of AN patients with RP. Among nutritional markers, HDL cholesterol, classically considered a protective cardiovascular factor, seems to correlate inversely with the microcirculation damage detected. This observation might provide a clue to investigate from a mechanistic point of view the relationship between AN, RP, and microcirculation damage. NIL. Table 1. NIL. None declared. [Display omitted] [Display omitted] Background:Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a more severe malnutrition. Limited data on a possible association with microcirculation damage in this context are published.Objectives:To characterize the microcirculation characteristics of anorexia nervosa patients through nailfold video capillaroscopy (NVC).Methods:Consecutive female patients with AN undergoing NVC due to RP and no known rheumatic disease were recruited. Controls (HC) were recruited among female subjects with a body mass index (BMI) >20 kg/m2 undergoing screening NVC due to RP and no concomitant rheumatic disease (primary RP). NVC was performed in each patient (digits II to V bilaterally). Two images taken at the center of each nailfold were evaluated by a single examiner to assess the presence of the following major microcirculation features: giant capillaries (defined by a diffuse >50 micrometers enlargement of a capillary loop), neoangiogenesis (bushy or deranged vessels), empty dermal papillae, hemosiderin deposits (dark deposits above capillaries suggestive of microhemorrages), microthromboses (cap-like hemosiderin deposits). Minimum and mean capillary density was registered. NEMO score was calculated as the cumulative number of hemosiderin deposits in all the examined digits. ANA (anti-nuclear antibodies) and ENA (anti extractible nuclear antigen antibodies) determination was available for all the recruited subjects. The following laboratory values related to nutritional status were collected for AN patients: hemoglobin, platelets, glucose, triglycerides, albumin, total serum proteins, urate, total, HDL and LDL cholesterol, folate, vitamin D, vitamin B12, prolactin, FSH, LH, complement C3 and C4. Weight and height were measured to calculate BMI.Results:Forty-seven AN patients with a mean age 25.5 ± 9.1 years and all with a BMI lower than 18.5 kg/m2, and 17 HC with a mean age 33.2 ± 10.5 years of were recruited. All the recruited subjects were negative for ANA and ENA. Compared to healthy controls, AN patients showed a significantly higher frequency of any of the considered capillaroscopic alterations (p=0.007) and in particular of empty dermal papillae (p=0.04). Among the considered laboratory values, HDL cholesterol level inversely correlated (point-biserial coefficient) with the presence of empty dermal papillae (p=0.032, R2=-0.476) and directly correlated (Pearson) with the mean capillary density (p=0.030, R2=0.396).Conclusion:We described the presence of microcirculation alterations in patients with anorexia nervosa without concomitant rheumatic diseases or autoantibody positivity. Microcirculation alterations and in particular the presence of empty dermal papillae, resembling a connective tissue disease NVC specific pattern, suggest the presence of a microcirculation damage in more than 30% of AN patients with RP. Among nutritional markers, HDL cholesterol, classically considered a protective cardiovascular factor, seems to correlate inversely with the microcirculation damage detected. This observation might provide a clue to investigate from a mechanistic point of view the relationship between AN, RP, and microcirculation damage.REFERENCES: NIL.Table 1.Figure 1.Capillaroscopy of a 22 years old female with anorexia nervosa and Raynaud’s phenomenon.Acknowledgements:NIL.Disclosure of Interests:None declared. |
| Author | Rinaldi, L. D’agostino, M. A. Policola, C. Boni, V. Moccia, L. Cerasuolo, P. G. Alonzi, G. Sani, G. Natalello, G. Bosello, S. L. Zoli, A. Murro, S. DI De Lorenzis, E. Pontecorvi, A. Fiore, S. Anesini, M. B. |
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| Snippet | Background:Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and... Increased prevalence of peripheral vascular symptoms like Raynaud’s phenomenon (RP) and acrocyanosis is reported in anorexia nervosa (AN) and correlates with a... |
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| SubjectTerms | Anorexia Autoantibodies Blood vessels Body mass index Capillaries Cholesterol Complement component C3 Complement component C4 Connective tissue diseases Diagnostic test Eating disorders Females Folic acid Follicle-stimulating hormone Hemoglobin High density lipoprotein Interdisciplinary research Low density lipoprotein Malnutrition Nutritional status Papillae Prolactin Rheumatic diseases Scientific Abstracts Serum proteins Skin Triglycerides Uric acid Vitamin B12 Vitamin D |
| Title | AB1496 MICROCIRCULATION CHARACTERIZATION IN ANOREXIA NERVOSA PATIENTS WITH RAYNAUD’S PHENOMENON |
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