Abstract
Aim. The study aims to assess the potential influences of rheumatoid arthritis (RA) and its specific disease measures on lean body composition phenotypes of female patients. Methods. The study was cross-sectionally designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. All the subjects gave written informed consent and the study was approved by the local ethics committee. Each subject underwent in the same day a clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. Correlations, differences and predictive power were analyzed with appropriate statistical tests. Results. The study included 107 RA patients and 104 controls. Compared to the normal subjects, who recorded higher levels of physical activity, the RA patients had significantly lower appendicular lean tissue absolute and relative indices and higher prevalence of sarcopenia. The whole body and appendicular lean tissue indices showed significant negative correlations with measures of disease severity (duration, inflammation, quality of life and radiographic progression), independent of age, levels of physical activity, body mass index and smoking. Conclusions. The measures of disease activity and severity independently predict lean tissue phenotypes in RA patients, behaving as risk factors for sarcopenia and rheumatoid cachexia. The diagnosis of RA in itself is a significant predictive factor of sarcopenia.
Highlights
Rheumatoid arthritis (RA) is a progressive autoimmune disease characterized by chronic inflammation which can lead to permanent joint deformity, disability, distress and socio-economic costs
This disease is associated with profound modifications of the body composition since the RA-lean tissue interaction leads to sarcopenia and rheumatoid cachexia [1]
The study was cross-sectionally designed to include all the patients admitted to our Rheumatology Department (Research Centre of the Pathology and Treatment of Systemic Rheumatic Diseases – RCRD, Bucharest) in the random order of presentation between May and August 2013, who fulfilled the following criteria: female sex; Caucasian race; postmenopausal status; 2010 ACR/EULAR classification criteria for RA [12] and more than 6 months disease duration
Summary
Rheumatoid arthritis (RA) is a progressive autoimmune disease characterized by chronic inflammation which can lead to permanent joint deformity, disability, distress and socio-economic costs This disease is associated with profound modifications of the body composition since the RA-lean tissue interaction leads to sarcopenia and rheumatoid cachexia [1]. The main pathogenic factors involved in the RA-associated muscle loss seem to be inadequate physical activity [2] and chronic inflammation-induced catabolism via cytokines such as tumor necrosis factor α [3] The study of these conditions is very relevant since sarcopenia and rheumatoid cachexia are associated with low quality of life, chronic fatigue, muscle weakness and adverse outcomes [4]. The use of the more appropriate dual X-ray absorptiometry (DXA) technique for body composition in RA is limited [7,8,9,10], especially regarding the whole body and regional muscle mass which are highly correlated with more sensitive estimations methods such
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