Abstract
To investigate the correlation between sarcopenia and nailfold microcirculation and serum 25-hydroxycholecalciferol [25 (OH) D3] (instead of 25-hydroxyvitamin D) and IL-17 levels in female rheumatoid arthritis (RA) patients. 130 female rheumatoid arthritis (RA) patients and 80 healthy controls were tested. Nailfold capillaroscopic scores (NFCS) were measured. Bioimpedance analysis (BIA) was used to measure skeletal muscle mass. Enzyme-linked immunosorbant assay (ELISA) was used to detect the levels of IL-17, IL-6 and TNF-α. Serum 25 (OH) D3 concentration was determined by photochemical immunoassay. The correlation was analyzed by Pearson's correlation, and the influencing factors were analyzed by binary logistic regression. (1) Compared with the control group, NFCS and serum IL-17 levels were higher in the RA group, while the serum 25 (OH) D3 and skeletal mass index (SMI) were lower. (2) Pearson correlation analysis found: SMI was positively correlated with 25 (OH) D3 (r=0.515, P<0.001), SMI was negatively correlated with IL-17 (r=-0.468, P<0.001), SMI was negatively correlated with NFS (r = -0.229, P=0.009); (3) Logistic regression analysis: serum 25 (OH) D3 was a protective factor for sarcopenia (OR=0.392, P=0.016); IL-17, C-reactive protein, and NFS were risk factors for sarcopenia (OR=1.516, P=0.049; OR=1.469, P=0.045; OR=3.497, P=0.002). Secondary sarcopenia in RA is common and is closely related to microcirculation abnormalities. Increased NFCS is a risk factor for sarcopenia. Decreased serum 25 (OH) D3 levels and increased IL-17 are also risk factors for sarcopenia, but the mechanisms involved in sarcopenia and microcirculation abnormalities need further investigation.
Highlights
Sarcopenia is a syndrome in which skeletal muscle volume loss and decreased strength are accompanied by physical dysfunction
(2) Pearson correlation analysis found: skeletal mass index (SMI) was positively correlated with 25 (OH) D3 (r=0.515, P
Nailfold capillaroscopic scores (NFCS), etc. as covariates in logistic regression analysis: serum 25 (OH) D3 was a protective factor for sarcopenia (OR=0.392, P=0.016); IL-17, C-reactive protein (CRP), NFCS were risk factors for sarcopenia (OR=1.516, P=0.049; OR=1.469, P=0.045; OR=3.497, P=0.002) (Table 3)
Summary
Sarcopenia is a syndrome in which skeletal muscle volume loss and decreased strength are accompanied by physical dysfunction. A variety of factors and mechanisms including chronic inflammation are involved in its occurrence. Rheumatoid arthritis (RA) is a common chronic inflammatory rheumatism in which serum interleukin 1 (IL-1), interleukin 6 (IL-6), and interleukin 17 (IL-17), tumor necrosis factor alpha (TNF-α) and other pro-inflammatory factors are increased. With the development of the disease, patients have varying degrees of joint damage, musculoskeletal damage, decreased balance, increased fracture risk and mortality[1], and, at the same time, sarcopenia significantly increases the risk of osteoporosis[2]. Research shows that microcirculation abnormalities occur in RA patients, which causes ischemic hypoxia in bone tissues, the gastrointestinal tract, kidneys, gonads and other organs closely related to bone metabolism, resulting in poor calcium absorption and transportation[3].
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