Nutritional status and its association with sarcopenic body composition phenotype and obesity in women with rheumatoid arthritis

Abstract

Purpose of the study. To evaluate the association of nutritional status with the presence of a sarcopenic body composition phenotype and obesity in postmenopausal women with rheumatoid arthritis.Materials and methods. The study included 121 postmenopausal women with RA (mean age 62.1 ± 7.9 years). Nutritional status was determined using the Russian version of the Mini Nutritional Assessment (MNA) questionnaire. Body composition was studied using dual-energy X-ray densitometry (‘Whole Body’ program). Clinical and laboratory examinations were also carried out.Results. Reduced nutritional status was detected in 42.1% of patients. Individuals with reduced nutritional status had a higher ESR and higher disease activity as assessed by the DAS28 index (p = 0.024 and p = 0.003, respectively), a greater 10-year likelihood of osteoporotic fractures of all major sites (p = 0.029) and hip fractures (p = 0.016). Correlations were established between nutritional status, according to the MNA questionnaire, and appendicular muscle mass (r = 0.21; p = 0.044), waist circumference (r = 0.32; p = 0.001) and waist-to-hip ratio (r = 0.29; p = 0.006), a negative association was found with DAS28 (r = –0.26; p = 0.009). Univariate logistic regression analysis showed an association of the sarcopenic phenotype with dietary calcium intake less than 500 mg/day (odds ratio [OR] = 7.55; 95% confidence interval [CI]: 3.09–18.44; p < 0.001), the shoulder circumference of the non-dominant arm is less than 25 cm (OR = 6.51; 95% CI: 2.21–19.12; p = 0.001). Obesity phenotype was associated with upper arm circumference greater than 25 cm (OR = 8.28; 95% CI: 2.78–24.66; p < 0.001) and serum vitamin D deficiency (OR = 1.04; 95% CI: 1.00–1.07; p = 0.043).Conclusions. The incidence of reduced nutritional status in postmenopausal women with RA according to MNA was 42.1%. An association was found between MNA nutritional status, daily calcium intake and the sarcopenic phenotype. No association with nutritional status was found for the obesity phenotype.