Department of Young Leaders’ Program in HealthCare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Rheumatology (Oxford). 2011 Jul;50(7):1250-8. doi: 10.1093/rheumatology/ker004. Epub 2011 Feb 3.
To characterize body composition phenotypes using a dual-energy X-ray absorptiometry (DXA) method and to explore factors potentially contributing to alterations in body composition in Vietnamese women with early RA.
A total of 105 women with early RA (disease duration ≤ 3 years) and 105 age-matched healthy women underwent physical examination, total and regional lean mass (LM) and fat mass (FM) with DXA. The 28-joint DAS (DAS-28) and disability using HAQ score, nutrition, physical activity and medications were recorded.
Means of weight and BMI were similar in RA patients and controls, but means of total body and trunk FM in RA patients were higher: 19.1 vs 16.9 kg (P = 0.007) and 10.1 vs 8.1 kg (P = 0.01), respectively, and appendicular LM was lower: 12.9 vs 14.1 kg (P = 0.02). The proportion of unhealthy body composition phenotypes (sarcopenia, overfat and sarcopenic obesity) in RA patients was higher (P < 0.001) than in controls. DAS-28 score was positively correlated with total FM and fat distribution ratio, and HAQ score was inversely correlated with appendicular LM. These body composition changes were associated with RF seropositivity, HAQ and DAS-28 scores.
Women with early RA had a significantly higher proportion of unhealthy body composition phenotypes, higher total and truncal FM and lower appendicular LM than controls. Disease activity and disability scores were associated with unhealthy body composition. These findings suggest that clinicians should encourage muscle strengthening and fat loss in RA patients to reduce their disability.
使用双能 X 射线吸收法（DXA）对身体成分表型进行特征描述，并探讨可能导致越南早期类风湿关节炎（RA）患者身体成分改变的因素。
共纳入 105 例早期 RA 患者（病程≤3 年）和 105 名年龄匹配的健康女性，进行体格检查、DXA 测量全身和局部瘦体重（LM）和脂肪量（FM）。记录 28 关节疾病活动度（DAS）（DAS-28）和残疾程度使用 HAQ 评分、营养、身体活动和药物。
RA 患者和对照组的体重和 BMI 均值相似，但 RA 患者的全身和躯干 FM 均值较高：19.1 千克比 16.9 千克（P=0.007）和 10.1 千克比 8.1 千克（P=0.01），四肢 LM 较低：12.9 千克比 14.1 千克（P=0.02）。RA 患者不健康身体成分表型（肌肉减少症、超重和肌肉减少性肥胖）的比例较高（P＜0.001）。DAS-28 评分与总 FM 和脂肪分布比值呈正相关，HAQ 评分与四肢 LM 呈负相关。这些身体成分变化与 RF 血清阳性、HAQ 和 DAS-28 评分相关。
与对照组相比，早期 RA 女性不健康身体成分表型的比例显著更高，全身和躯干 FM 更高，四肢 LM 更低。疾病活动度和残疾评分与不健康的身体成分有关。这些发现表明，临床医生应鼓励 RA 患者进行肌肉强化和减脂，以降低残疾程度。
