Department of Medicine, Central Hospital of Lapland, Rovaniemi, Finland.
Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.
PLoS One. 2018 Apr 9;13(4):e0194917. doi: 10.1371/journal.pone.0194917. eCollection 2018.
Increasing evidence suggests that inflammation has a detrimental effect on muscle strength. Our objective was to analyse the association between muscle performance and different disease activity levels in patients with rheumatoid arthritis (RA).
A total of 199 consecutive outpatients were subject to cross-sectional assessment. Measurements of grip strength, endurance of the upper and lower limbs and trunk strength were combined as a muscle performance composite score (MPCS), using a standardised method. The disease activity for 28 joints (DAS28), radiographs of small joints (Larsen score), rheumatoid factor, body mass index (BMI), comorbidities and anti-rheumatic drugs were verified. Patients' questionnaires included sociodemographic information, pain level, global disease activity, the Beck Depression Inventory, the mental and physical component scores of Short Form-36 and physical activity level.
Of the 199 patients, 36%, 17% and 47% patients had remission, low/moderate and high DAS28, respectively. The patients in remission had significantly shorter disease duration, better parameters in terms of pain, physician's assessment, Larsen, Beck or physical component score of Short Form-36, and they were more physically active than other patients. After adjustments for age, sex, RA duration, radiographs and BMI, the decreasing MPCS associated linearly with the increasing DAS28 activity levels (linearity, P <0.001).
Poorer MPCS is clearly associated with higher disease activity in patients with RA. Muscle performance is a modifiable risk factor. The findings suggest evaluating muscle performance in clinical practice as a part of patient care.
越来越多的证据表明，炎症对肌肉力量有不利影响。我们的目的是分析类风湿关节炎（RA）患者的肌肉表现与不同疾病活动水平之间的关系。
共对 199 例连续门诊患者进行了横断面评估。采用标准化方法，将握力、上下肢耐力和躯干力量的测量值组合为肌肉表现综合评分（MPCS）。验证了 28 个关节疾病活动度（DAS28）、小关节射线照相（ Larsen 评分）、类风湿因子、体重指数（BMI）、合并症和抗风湿药物。患者问卷包括社会人口统计学信息、疼痛程度、总体疾病活动度、贝克抑郁量表、SF-36 量表的心理和生理成分评分以及身体活动水平。
199 例患者中，缓解、低/中度和高 DAS28 患者分别占 36%、17%和 47%。缓解期患者的疾病持续时间明显更短，疼痛、医生评估、Larsen、贝克或 SF-36 量表的生理成分评分等参数更好，且比其他患者更活跃。调整年龄、性别、RA 持续时间、射线照相和 BMI 后，MPCS 与 DAS28 活动水平呈线性下降相关（线性，P <0.001）。
RA 患者的 MPCS 较差与疾病活动度较高明显相关。肌肉表现是一个可改变的危险因素。这些发现表明，在临床实践中评估肌肉表现是患者护理的一部分。
