Abstract
BackgroundAn unfavorable body composition is often present in chronic arthritis patients. This unfavorable composition is a loss of muscle mass, with a stable or increased (abdominal) fat mass. Since it is unknown when this unfavorable composition develops, we compared body composition in disease-modifying antirheumatic drugs (DMARD)-naive early arthritis patients with non-arthritis controls and explored the association, in early arthritis patients, with disease activity and traditional cardiovascular risk factors.Methods317 consecutive early arthritis patients (84% rheumatoid arthritis according to 2010 ACR/EULAR criteria) and 1268 age-/gender-/ethnicity-matched non-arthritis controls underwent a Dual-energy X-ray absorptiometry scan to assess fat percentage, fat mass index, fat mass distribution and appendicular lean (muscle) mass index. Additionally, disease activity, health assessment questionnaire (HAQ), acute phase proteins, lipid profile and blood pressure were evaluated.ResultsLoss of muscle mass (corrected for age suspected muscle mass) was 4–5 times more common in early arthritis patients, with a significantly lower mean appendicular lean mass index (females 6% and males 7% lower, p<0.01). Patients had more fat distributed to the trunk (females p<0.01, males p = 0.07) and females had a 4% higher mean fat mass index (p<0.01). An unfavorable body composition was associated with a higher blood pressure and an atherogenic lipid profile. There was no relationship with disease activity, HAQ or acute phase proteins.ConclusionLoss of muscle mass is 4–5 times more common in early arthritis patients, and is in early arthritis patients associated with a higher blood pressure and an atherogenic lipid profile. Therefore, cardiovascular risk is already increased at the clinical onset of arthritis making cardiovascular risk management necessary in early arthritis patients.
Highlights
Inflammatory arthritis, especially rheumatoid arthritis (RA), is associated with an increased mortality [1, 2] and mainly due to cardiovascular (CV) disease[3,4,5,6]
Loss of muscle mass was 4–5 times more common in early arthritis patients, with a significantly lower mean appendicular lean mass index
Loss of muscle mass is 4–5 times more common in early arthritis patients, and is in early arthritis patients associated with a higher blood pressure and an atherogenic lipid profile
Summary
Inflammatory arthritis, especially rheumatoid arthritis (RA), is associated with an increased mortality [1, 2] and mainly due to cardiovascular (CV) disease[3,4,5,6]. Several studies have documented that inflammatory arthritis patients have an unfavorable body composition compared to healthy controls[14,15,16,17,18,19] Their condition comprises a loss of skeletal muscle mass (more than suspected for their age), in the presence of stable or even increased fat mass (especially on the abdomen), resulting in a stable weight[20]. This unfavorable composition is a loss of muscle mass, with a stable or increased (abdominal) fat mass Since it is unknown when this unfavorable composition develops, we compared body composition in disease-modifying antirheumatic drugs (DMARD)-naive early arthritis patients with non-arthritis controls and explored the association, in early arthritis patients, with disease activity and traditional cardiovascular risk factors
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