Rheumatology Department, Instituto Nacional de Rehabilitación "Guillermo Ibarra Ibarra", Mexico City, Mexico.
Heart Failure and Respiratory Distress Clinic, Cardiology Department, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosio Villegas", Mexico City, Mexico.
Clin Rheumatol. 2018 Mar;37(3):607-614. doi: 10.1007/s10067-017-3889-x. Epub 2017 Nov 8.
Rheumatoid arthritis (RA) patients frequently have changes in their body composition, with a decrease in muscle mass and an increase in fat mass, a syndrome that is termed rheumatoid cachexia (RC). The prevalence of this nutritional alteration is not well known; there is as yet no consensus, seeing as it depends on the methods, techniques, and cutoff points that are used for its diagnosis. The main aim of this study was to identify RC through assessment by bioelectrical impedance vector analysis (BIVA) and its association with metabolic causes, physical function, and the main disease status, among others. The prevalence of RC was identified in those subjects who fell outside the right lower quadrant of the reference curve of RXc graph of BIVA. Clinical, anthropometric, biochemical and physical activity, emotional status, and diet markers were also evaluated. Ninety-four patients were included (92.55% women). The prevalence of RC assessed by BIVA was 21.28%. BIVA-cachexia patients had a lesser value of handgrip strength vs. patients without BIVA-cachexia 10.2 kg (7.2-13.4) vs. 14.7 kg (9.6-19), p = 0.0062. Disability and folic acid with methotrexate consumption are related to BIVA-cachexia ((OR 4.69, 95% CI 1.33, 16.54, p = 0.016) and (OR 0.19, 95%CI 0.058, 0.651, p = 0.008), respectively). BIVA could represent a valuable tool to assess presence of RC. It is important that RA patients have physical therapy to improve their nutritional status.
类风湿关节炎（RA）患者常出现身体成分改变，肌肉量减少，脂肪量增加，这种综合征称为类风湿性恶病质（RC）。这种营养改变的患病率尚不清楚；目前尚无共识，因为它取决于用于诊断的方法、技术和截断点。本研究的主要目的是通过生物电阻抗向量分析（BIVA）评估来识别 RC，并确定其与代谢原因、身体功能和主要疾病状况等的关联。通过 BIVA 评估，将那些位于 BIVA 的 RXc 图参考曲线右下象限之外的患者定义为 RC。还评估了临床、人体测量学、生化和身体活动、情绪状态和饮食标志物。共纳入 94 例患者（92.55%为女性）。通过 BIVA 评估的 RC 患病率为 21.28%。BIVA-恶病质患者的握力值低于无 BIVA-恶病质患者，分别为 10.2kg（7.2-13.4）和 14.7kg（9.6-19），p=0.0062。残疾和叶酸与甲氨蝶呤的使用与 BIVA-恶病质相关（OR 4.69，95%CI 1.33，16.54，p=0.016）和（OR 0.19，95%CI 0.058，0.651，p=0.008）。BIVA 可能是评估 RC 存在的有价值工具。RA 患者需要进行物理治疗以改善其营养状况。
