Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
Department of Orthopedic Surgery, Kariya Toyota General Hospital, Kariya, Aichi, Japan.
Mod Rheumatol. 2021 Jan;31(1):101-107. doi: 10.1080/14397595.2020.1744828. Epub 2020 Mar 30.
This study aimed to longitudinally evaluate the association between rheumatoid arthritis (RA) and locomotive syndrome (LS) in RA patients using the 25-question Geriatric Locomotive Function Scale (GLFS-25).
Subjects were 58 RA patients (female, 48 (82.8%); mean age, 60.9 ± 10.9 years) who had GLFS-25 scores available for five consecutive years and who did not have LS at baseline (i.e. GLFS-25 < 16 points). Associations between DAS28-CRP and the development of LS were determined using linear regression analysis and receiver operating characteristic (ROC) curve analysis.
Subjects were divided into the LS group ( = 15, GLFS-25 ≥ 16 points) and non-LS group ( = 43, GLFS-25 < 16 points) based on GLFS-25 scores at the 5th year of the study period. In the LS group, DAS28-CRP worsened every year. The linear regression model adjusted for age and sex revealed that ΔGLFS-25 increased by 3.80 (95% confidence interval: 1.81-5.79) each time ΔDAS28-CRP increased by 1 (<.001). Among patients in remission (DAS28-CRP < 2.3), 13.5% had LS. ROC curve analysis yielded a five-year mean DAS28-CRP of 1.99 (sensitivity, 86.7%; specificity, 62.8%) as the cut-off point for the development of LS.
Tight control of RA disease activity for deeper remission may be needed to prevent the development of LS.
本研究旨在使用 25 项老年机能量表（GLFS-25），对类风湿关节炎（RA）患者进行纵向评估，以研究 RA 与行动不便综合征（LS）之间的关系。
研究对象为 58 名 RA 患者（女性 48 例，占 82.8%；平均年龄 60.9±10.9 岁），他们在连续 5 年内都有 GLFS-25 评分，并在基线时没有 LS（即 GLFS-25<16 分）。使用线性回归分析和受试者工作特征（ROC）曲线分析，确定 DAS28-CRP 与 LS 发展之间的关系。
根据研究期间第 5 年的 GLFS-25 评分，将患者分为 LS 组（ = 15，GLFS-25≥16 分）和非 LS 组（ = 43，GLFS-25<16 分）。在 LS 组中，DAS28-CRP 每年都在恶化。经年龄和性别调整的线性回归模型显示，每次 DAS28-CRP 增加 1 时，ΔGLFS-25 增加 3.80（95%置信区间：1.81-5.79）（<.001）。在缓解期（DAS28-CRP<2.3）的患者中，有 13.5%的患者出现 LS。ROC 曲线分析显示，5 年平均 DAS28-CRP 为 1.99（敏感性为 86.7%，特异性为 62.8%），作为发生 LS 的截断值。
可能需要更严格地控制 RA 疾病活动度以达到更深层次的缓解，从而预防 LS 的发生。
