类风湿关节炎患者肌少症的患病率及相关危险因素：系统评价和荟萃回归分析。

The prevalence and risk factors of sarcopenia in rheumatoid arthritis patients: A systematic review and meta-regression analysis.

机构信息

Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Rd., Taipei, Shihlin District 111 Taiwan; Institute of Clinical Medicine, National Yang-Ming University, No.155, Sec.2, Linong St., Taipei City, Beitou District 112 Taiwan; Faculty of Medicine, National Yang-Ming University, No.155, Sec.2, Linong St., Taipei City, Beitou District 112 Taiwan.

Institute of Biomedical Informatics, National Yang-Ming University, No.155, Sec.2, Linong St., Taipei City, Beitou District 112 Taiwan; Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, No. 291 Zhong-zheng Road, New Taipei City, Zhonghe District, Taiwan; Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei city, Taiwan.

出版信息

Semin Arthritis Rheum. 2021 Feb;51(1):236-245. doi: 10.1016/j.semarthrit.2020.10.002. Epub 2020 Dec 17.

DOI:10.1016/j.semarthrit.2020.10.002

PMID:33385864

Abstract

BACKGROUND

Sarcopenia is an ever-increasingly recognized entity in aging or chronically-ill individuals. A recent surge of researches came out on sarcopenia in rheumatoid arthritis (RA). However, the results varied widely. We tried to assess the prevalence of and associated factors with sarcopenia in patients with RA.

METHODS

We searched the investigations dealing with the prevalence of and associated factors with sarcopenia in RA from PubMed, EMBASE, CENTRAL, EBSCOhost, Airiti Library, CEPS, CNKI and J-STAGE from the inception to January 11, 2020. Effects regarding prevalence and associated factors were extracted and evaluated by random-effects model. Sensitivity analysis was also performed.

RESULTS

Seventeen studies containing 3,140 RA subjects were identified. After exclusion of outliers, the pooled prevalence of sarcopenia was 31%. Neither ongoing-study districts nor diagnostic modalities affected prevalence significantly. Any associated factors being mentioned in at least two publications were analyzed, yielding functional limitation (Steinbrocker stage III/IV), high CRP and RF seropositivity as the significant risk factors. Based on disease durations, we carried out meta-regression and found DAS28 and HAQ are predictive models. There was no alteration in the interpretation of results from sensitivity analysis after removal of any studies skewed in sampling distribution.

CONCLUSIONS

The prevalence of sarcopenia in patients with RA is high, compared to that in general counterparts. Disease duration rather than age, residing area or diagnostic modalities influences sarcopenia development; DAS28 and HAQ predict occurrence. High index of suspicion to facilitate early detection of sarcopenia in RA patients is important.

摘要

背景

在衰老或慢性病患者中，肌肉减少症是一种日益被认识到的病症。最近，关于类风湿关节炎（RA）中肌肉减少症的研究大量涌现。然而，结果差异很大。我们试图评估 RA 患者中肌肉减少症的患病率和相关因素。

方法

我们从 PubMed、EMBASE、CENTRAL、EBSCOhost、Airiti Library、CEPS、CNKI 和 J-STAGE 搜索了从创建到 2020 年 1 月 11 日关于 RA 中肌肉减少症患病率和相关因素的研究。通过随机效应模型提取和评估与患病率和相关因素有关的效果。还进行了敏感性分析。

结果

确定了 17 项包含 3140 名 RA 患者的研究。排除离群值后，肌肉减少症的总患病率为 31%。持续研究地区或诊断方式均未显著影响患病率。至少有两种出版物提到的任何相关因素均进行了分析，得出功能受限（Steinbrocker 分期 III/IV）、高 CRP 和 RF 血清阳性为显著危险因素。根据疾病持续时间，我们进行了元回归分析，发现 DAS28 和 HAQ 是预测模型。在去除任何抽样分布偏倚的研究后，敏感性分析的结果解释没有改变。