Nutritional status and osteoporotic phenotype of body composition in patients with rheumatoid arthritis

Abstract

Aim. To evaluate the nutritional status and its relationship with osteoporotic phenotype of body composition in women with rheumatoid arthritis (RA).Material and methods. The study included 91 women aged 40 to 75 years with RA according to ACR/EULAR criteria (2010). A questionnaire, laboratory examination and dual X-ray absorptiometry of whole body, lumbar spine and proximal femur were conducted. Nutritional status was assessed using a MNA (Mini Nutricial Assessment) questionnaire.Results. Risk of malnutrition and malnutrition according to the MNA were detected in 42.9 % and 1.1 % of patients with RA, respectively. These patients differed from those with normal nutritional status with a higher risk of osteoporotic hip fracture according to FRAX (p = 0.035), lower appendicular muscle mass (AMM) (p = 0.048) and lower QOL according to VAS (p = 0.012). A positive correlation was established between the nutritional status by MNA and BMI (r = 0.280; p = 0.007), as well as total muscle mass (r = 0.280; p = 0.008), AMM (r = 0.320; p = 0.002) and AMM index (r = 0.280; p = 0.009). In multivariate logistic regression analysis, age above 55 years (OR = 7.76; 95 % CI: 2.17–27.69), nutritional status by MNA (OR = 0.68; 95 % CI: 0.51–0.92) and AMM index less than 6 kg/m2 (OR = 3.43; 95 % CI: 1.16–10.21) were independent factors associated with osteoporotic phenotype in RA patients.Conclusion. Malnutrition occurred in 44.0 % of RA patients. Women at risk of malnutrition had a higher 10-year probability of hip fracture according to FRAX. Age and AMM index were positively associated, while nutrition status according to MNA was negatively associated with osteoporotic phenotype of body composition.