AB1496 MICROCIRCULATION CHARACTERIZATION IN ANOREXIA NERVOSA PATIENTS WITH RAYNAUD’S PHENOMENON
Authors: G. Natalello, A. Zoli, P. G. Cerasuolo, S. DI Murro, G. Alonzi, S. Fiore, V. Boni, E. De Lorenzis, C. Policola, L. Moccia, M. B. Anesini, L. Rinaldi, G. Sani, A. Pontecorvi, M. A. D’agostino, S. L. Bosello
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> 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. <h3>Objectives:</h3> To characterize the microcirculation characteristics of anorexia nervosa patients through nailfold video capillaroscopy (NVC). <h3>Methods:</h3> 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) &gt;20 kg/m<sup>2</sup> 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 &gt;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. <h3>Results:</h3> Forty-seven AN patients with a mean age 25.5 ± 9.1 years and all with a BMI lower than 18.5 kg/m<sup>2</sup>, 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, R<sup>2</sup>=-0.476) and directly correlated (Pearson) with the mean capillary density (p=0.030, R<sup>2</sup>=0.396). <h3>Conclusion:</h3> 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. <b>Table 1.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>