Institute for Experimental Medical Research and KG Jebsen Center for Cardiac Research, Oslo University Hospital-Ullevål and University of Oslo.
Institute for Clinical Medicine, Medical Faculty, University of Oslo.
Rheumatology (Oxford). 2022 Jul 6;61(7):2959-2968. doi: 10.1093/rheumatology/keab805.
To compare body composition parameters in patients with long-standing JDM and controls and to explore associations between body composition and disease activity/inflammation, muscle strength, health-related quality of life (HRQoL) and cardiometabolic measures.
We included 59 patients (median disease duration 16.7 y; median age 21.5 y) and 59 age- and sex-matched controls in a cross-sectional study. Active and inactive disease were defined by the PRINTO criteria. Body composition was assessed by total body DXA, inflammation by high-sensitivity CRP (hs-CRP) and cytokines, muscle strength by the eight-muscle manual muscle test, HRQoL by the 36-item Short Form Health Survey physical component score and cardiometabolic function by echocardiography (systolic and diastolic function) and serum lipids.
DXA analyses revealed lower appendicular lean mass index (ALMI; reflecting limb skeletal muscle mass), higher body fat percentage (BF%) and a higher android fat:gynoid fat (A:G) ratio (reflecting central fat distribution) in patients than controls, despite similar BMI. Patients with active disease had lower ALMI and higher BF% than those with inactive disease; lower ALMI and higher BF% were associated with inflammation (elevated monocyte attractant protein-1 and hs-CRP). Lower ALMI was associated with reduced muscle strength, while higher BF% was associated with impaired HRQoL. Central fat distribution (higher A:G ratio) was associated with impaired cardiac function and unfavourable serum lipids.
Despite normal BMI, patients with JDM, especially those with active disease, had unfavourable body composition, which was associated with impaired HRQoL, muscle strength and cardiometabolic function. The association between central fat distribution and cardiometabolic alterations is a novel finding in JDM.
比较长期皮肌炎（JDM）患者与对照者的人体成分参数，并探讨人体成分与疾病活动/炎症、肌肉力量、健康相关生活质量（HRQoL）和心血管代谢指标之间的相关性。
我们纳入了 59 名皮肌炎患者（中位病程 16.7 年；中位年龄 21.5 岁）和 59 名年龄和性别匹配的对照者进行横断面研究。根据 PRINTO 标准定义活动期和非活动期疾病。通过全身双能 X 线骨密度仪（DXA）评估人体成分，通过高敏 C 反应蛋白（hs-CRP）和细胞因子评估炎症，通过 8 肌肉手动肌肉测试评估肌肉力量，通过 36 项简明健康调查问卷（SF-36）物理成分评分评估 HRQoL，通过超声心动图（收缩和舒张功能）和血清脂质评估心血管代谢功能。
DXA 分析显示，与对照者相比，患者的四肢瘦体重指数（ALMI；反映四肢骨骼肌量）较低，体脂肪百分比（BF%）较高，躯干脂肪：臀部脂肪（A：G）比值较高（反映中心脂肪分布），尽管 BMI 相似。活动期疾病患者的 ALMI 低于非活动期疾病患者，BF%高于非活动期疾病患者；较低的 ALMI 和较高的 BF%与炎症（升高的单核细胞趋化蛋白-1 和 hs-CRP）相关。较低的 ALMI 与肌肉力量下降相关，而较高的 BF%与 HRQoL 受损相关。中心脂肪分布（较高的 A：G 比值）与心脏功能受损和血脂异常有关。
尽管 BMI 正常，JDM 患者，尤其是活动期疾病患者，其人体成分仍不理想，与 HRQoL、肌肉力量和心血管代谢功能受损相关。中心脂肪分布与心血管代谢改变之间的关联是 JDM 的一个新发现。
