Department of Rheumatology, Malmö University Hospital, Malmö, Sweden.
Scand J Rheumatol. 2011 Mar;40(2):95-100. doi: 10.3109/03009742.2010.507215. Epub 2010 Sep 26.
Rheumatoid arthritis (RA) is associated with cardiovascular disease (CVD). Possible predictors for CVD are early changes in body composition. We therefore evaluated changes in lean body mass (LBM), lean mass of arms and legs (LMAL), total body fat mass (BFM), and truncal fat distribution (FD) after 2 years with RA and possible predictors.
We registered 63 (45 women) RA patients with disease duration of ≤ 12 months at baseline and after 2 years. Disease Activity Score using 28 joint counts (DAS28), Health Assessment Questionnaire (HAQ) score, body mass index (BMI), comorbidities, smoking, and medications were recorded. Total and regional lean mass and fat mass were measured with dual energy X-ray absorptiometry (DXA). The data were compared with 63 age- and gender-matched controls.
LBM and LMAL at baseline in RA patients were significantly lower in men (p = 0.020 and 0.002, respectively) compared to matched controls. Truncal FD was non-significantly increased in RA patients (women p = 0.133, men p = 0.119). The age-related deterioration with decreased LBM after 2 years (p = 0.002 in women and men) and increased BFM (p < 0.001) and truncal FD (p = 0.020) in women were all significantly less pronounced in RA patients than in matched controls.
In patients with early RA and after initiation of therapy, the age-related deterioration with decreasing LBM and increasing truncal FD was lower than in control subjects in this observational study. These potentially harmful alterations seem to be modifiable factors in patients with early RA.
类风湿关节炎（RA）与心血管疾病（CVD）相关。心血管疾病的可能预测因素是身体成分的早期变化。因此，我们评估了 RA 患者在 2 年内的瘦体重（LBM）、手臂和腿部的瘦体重（LMAL）、全身脂肪量（BFM）和躯干脂肪分布（FD）的变化以及可能的预测因素。
我们登记了 63 名（45 名女性）基线疾病持续时间≤12 个月的 RA 患者，并在 2 年后进行了随访。使用 28 关节计数的疾病活动评分（DAS28）、健康评估问卷（HAQ）评分、体重指数（BMI）、合并症、吸烟和药物记录。采用双能 X 射线吸收法（DXA）测量总身体和区域瘦体重和脂肪量。将这些数据与 63 名年龄和性别匹配的对照组进行比较。
RA 患者的男性基线 LBM 和 LMAL 明显低于匹配对照组（p=0.020 和 0.002）。RA 患者的躯干 FD 非显著增加（女性 p=0.133，男性 p=0.119）。2 年后，女性的 LBM 随年龄下降（p=0.002），BFM 增加（p<0.001），躯干 FD 增加（p=0.020），与匹配对照组相比，RA 患者的这些变化明显较小。
在这项观察性研究中，与匹配对照组相比，早期 RA 患者在开始治疗后，LBM 随年龄下降和躯干 FD 增加的年龄相关恶化程度较低。这些潜在的有害改变似乎是早期 RA 患者的可调节因素。
