Morphological Parameters in Quadriceps Muscle Were Associated with Clinical Features and Muscle Strength of Women with Rheumatoid Arthritis: A Cross-Sectional Study.

Rafael Mendonça da Silva Chakr,Émerson Pena,Ricardo Machado Xavier,Lucas Denardi Dória,Odirlei André Monticielo,Vanessa Hax,Claiton Viegas Brenol,Rafaela Cavalheiro do Espírito Santo,Leonardo Peterson dos Santos

doi:10.3390/diagnostics11112014

Rafael Mendonça da Silva Chakr, Émerson Pena + Show 7 more

Open Access

https://doi.org/10.3390/diagnostics11112014

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Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune, inflammatory and chronic disease that may lead to loss of muscle mass, muscle strength and decreased functionality. Our objectives are to assess the quadriceps muscle morphology by ultrasound (MU) and verify its associations with clinical features, muscle strength and physical function in RA patients. Methods: In this cross-sectional study, RA women (≥18 years) were included. Morphological parameters in quadriceps muscle consisted of the muscle thickness and pennation angle of rectus femoris (RF), vastus intermedius (VI) and vastus lateralis (VL). RA activity was measured by a 28-joint disease activity score (DAS28), muscle strength by handgrip and chair stand tests, and physical function by health assessment questionnaire (HAQ), timed-up-and-go (TUG) test and short physical performance battery (SPPB). Results: Fifty-five patients were included (age: 56.73 ± 9.46 years; DAS28: 3.08 ± 1.29). Muscle thickness in RF, VI and VL were negatively associated with age (RF, p < 0.001; VI, p = 0.013; VL, p = 0.002) and disease duration (RF, p < 0.001; VI, p = 0.005; VL, p = 0.001), and were positively associated with handgrip strength (RF, p = 0.015; VI, p = 0.022; VL, p = 0.013). In addition, decreased muscle thickness in VI (p = 0.035) and a smaller pennation angle in RF (p = 0.030) were associated with higher DAS-28 scores. Conclusion: Quadriceps muscle morphology by ultrasound appears to be affected by age, disease duration, disease activity and muscle strength in patients with RA. MU can be a useful method to evaluate the impact of the disease on skeletal muscle.

Highlights

Rheumatoid arthritis (RA) is an autoimmune, inflammatory and chronic arthropathy [1] that may present extra-articular manifestations [2,3]
The main findings of this study were that RA patients with lower muscle strength present impairment of muscle thickness of rectus femoris (RF) and vastus lateralis (VL), as well as RF pennation angle
The muscle thickness of RF and VL were associated with age, disease duration, chair stand (5-repetition) and handgrip strength, while the vastus intermedius (VI) was associated with age, disease duration, DAS28-C-reactive protein (CRP) and handgrip strength

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune, inflammatory and chronic arthropathy [1] that may present extra-articular manifestations [2,3]. RA patients are shown to have lower muscle mass adjusted by fat mass and lower muscle density, a composite index of intramuscular fat substitution, compared to a healthy representative sample [12,13]. Factors such as increased pro-inflammatory cytokines [2,3,14], glucocorticoids use [15], exercise intolerance and sedentary behavior [16]. Rheumatoid arthritis (RA) is an autoimmune, inflammatory and chronic disease that may lead to loss of muscle mass, muscle strength and decreased functionality. Results: Fifty-five patients were included (age: 56.73 ± 9.46 years; DAS28: 3.08 ± 1.29)

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