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类风湿关节炎疾病活动度和残疾对类风湿恶病质的影响。

Contribution of rheumatoid arthritis disease activity and disability to rheumatoid cachexia.

机构信息

Department of Diabetes, Endocrinology and Rheumatology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, Kyoto 605-0981, Japan.

出版信息

Mod Rheumatol. 2010 Oct;20(5):439-43. doi: 10.1007/s10165-010-0306-6. Epub 2010 May 28.

Abstract

This cross-sectional study was done to show how nutritional indices influence each other and the contributions made by inflammation to the development of rheumatoid cachexia. We studied 295 female patients with rheumatoid arthritis (RA). We chose five nutritional indices: body mass index (BMI), arm muscle area (AMA), triceps skinfold thickness (TSF), which were obtained via anthropometric measurements, and serum albumin and cholesterol. Clinical indicators of RA included disease duration, C-reactive protein (CRP) and Disease Activity Score 28 (DAS28). We performed a bivariate correlation test between the nutritional indices and multiple regression analysis for each nutritional index. Mean AMA was low, 87.3% of the normal value, whereas TSF was not different. Muscle protein expressed by AMA decreased according to RA duration, whereas visceral protein indicated by serum albumin decreased with an increase in RA activity. The continuation of inflammation appears to be essential for a decrease in muscle protein in rheumatoid cachexia. DAS28 showed a positive contribution to BMI in the regression model, and the increase in RA disease activity causes an increase in BMI via an accumulation of tissue fat.

摘要

本横断面研究旨在展示营养指数如何相互影响,以及炎症对类风湿性恶病质发展的贡献。我们研究了 295 名女性类风湿关节炎(RA)患者。我们选择了五个营养指数:通过人体测量获得的体重指数(BMI)、手臂肌肉面积(AMA)、三头肌皮褶厚度(TSF)以及血清白蛋白和胆固醇。RA 的临床指标包括疾病持续时间、C 反应蛋白(CRP)和 28 个关节疾病活动度评分(DAS28)。我们对营养指数进行了双变量相关检验,并对每个营养指数进行了多元回归分析。平均 AMA 较低,为正常值的 87.3%,而 TSF 则没有差异。AMA 所表示的肌肉蛋白随着 RA 持续时间的延长而减少,而血清白蛋白所表示的内脏蛋白则随着 RA 活性的增加而减少。炎症的持续存在似乎是类风湿性恶病质中肌肉蛋白减少的必要条件。DAS28 在回归模型中对 BMI 有积极贡献,RA 疾病活动度的增加通过组织脂肪的积累导致 BMI 增加。

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