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日本类风湿关节炎患者与肌肉减少症相关的因素:一项横断面研究。

Sarcopenia-associated factors in Japanese patients with rheumatoid arthritis: A cross-sectional study.

机构信息

Department of Orthopedic Surgery, Kamagaya General Hospital, Chiba, Japan.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Geriatr Gerontol Int. 2019 Sep;19(9):907-912. doi: 10.1111/ggi.13747. Epub 2019 Jul 24.

Abstract

AIM

To evaluate the prevalence rate and factors associated with sarcopenia in Japanese patients with rheumatoid arthritis.

METHODS

We enrolled 240 consecutive patients with rheumatoid arthritis aged ≥65 years in this study. We examined clinical data: age, sex, body mass index, disease duration, rheumatoid factor positivity, anti-cyclic citrullinated peptide antibody positivity, biological or target synthetic disease-modifying antirheumatic drug use, methotrexate use, glucocorticoid use, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate, Health Assessment Questionnaire Disability Index, bone mineral density of the lumbar spine and total hip, grip strength, gait speed, and relative skeletal muscle mass index by bioelectrical impedance analysis. Sarcopenia was defined according to a consensus report by the Asian Working Group for Sarcopenia.

RESULTS

The prevalence rate of sarcopenia was found to be 29.6%. Multivariate analysis identified the following factors to be associated with sarcopenia: age (P = 0.008; odds ratio 1.08), body mass index (P < 0.001; odds ratio 0.73), C-reactive protein (P = 0.017; odds ratio 1.76) and hip bone mineral density (P = 0.037; odds ratio 0.61).

CONCLUSIONS

The sarcopenia-associated factors were age, body mass index, C-reactive protein and hip bone mineral density in Japanese patients with rheumatoid arthritis. Because the Health Assessment Questionnaire Disability Index, a standard measurement of function, cannot predict sarcopenia, the muscle mass needs to be measured while assessing changes in grip strength, body mass index, C-reactive protein and hip bone mineral density. Geriatr Gerontol Int 2019; 19: 907-912.

摘要

目的

评估日本类风湿关节炎患者中肌少症的患病率及其相关因素。

方法

本研究纳入了 240 例年龄≥65 岁的连续类风湿关节炎患者。我们检查了临床数据:年龄、性别、体重指数、病程、类风湿因子阳性、抗环瓜氨酸肽抗体阳性、生物或靶向合成改善病情抗风湿药物、甲氨蝶呤、糖皮质激素、C 反应蛋白水平、28 关节红细胞沉降率疾病活动评分、健康评估问卷残疾指数、腰椎和全髋关节骨密度、握力、步态速度和生物电阻抗分析的相对骨骼肌质量指数。肌少症根据亚洲肌少症工作组的共识报告进行定义。

结果

肌少症的患病率为 29.6%。多变量分析确定了与肌少症相关的以下因素:年龄(P = 0.008;优势比 1.08)、体重指数(P<0.001;优势比 0.73)、C 反应蛋白(P = 0.017;优势比 1.76)和髋部骨密度(P = 0.037;优势比 0.61)。

结论

在日本类风湿关节炎患者中,肌少症的相关因素是年龄、体重指数、C 反应蛋白和髋部骨密度。由于健康评估问卷残疾指数是功能的标准测量方法,不能预测肌少症,因此在评估握力、体重指数、C 反应蛋白和髋部骨密度变化时,需要测量肌肉质量。老年医学与老年病学国际 2019;19:907-912。

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