Rheumatology Department, Hospital Central do Funchal, Madeira; Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.
Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisbon,and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal.
Clin Exp Rheumatol. 2022 Feb;40(2):267-273. doi: 10.55563/clinexprheumatol/9ljng7. Epub 2021 Nov 23.
We aimed to investigate muscle physical properties, strength, mass, physical performance, and the prevalence of sarcopenia in patients with axial spondylarthritis (axSpA) compared to the healthy controls (HC).
We performed a cross-sectional study on 54 participants: 27 patients with axSpA and 27 HC, matched by age, gender, and level of physical activity. Muscle physical properties (stiffness, tone and elasticity), muscle strength (five-times sit-to-stand [5STS] test), muscle mass, physical performance (measured through gait speed) and sarcopenia were compared between the groups. Linear regression models were conducted allowing adjustment for relevant variables.
Patients with axSpA (mean age 36.5 (SD 7.5) years, 67% males, mean disease duration 6.5 (3.2) years) had no significant difference in segmental muscle stiffness, tone or elasticity, compared with the HC, despite showing a slight numerically higher lower lumbar (L3-L4) stiffness [median 246.5 (IQR 230.5-286.5) vs. 232.5 (211.0-293.5), p=0.38]. No participants presented sarcopenia. Patients with axSpA, compared to the HC, had lower total strength [B=1.88 (95% CI 0.43;3.33)], as well as lower strength in the upper (B=-17.02 (-27.33;-6.70)] and lower limbs [B=-11.14 (-18.25;-4.04)], independently of muscle physical properties. Patients had also significantly lower gait speed than the HC [B=-0.11 (-0.21;-0.01)], adjusted for muscle mass, strength and muscle physical properties.
Young axSpA patients with a relatively short disease duration presented similar segmental muscle physical properties as the HC and had no sarcopenia. Patients with axSpA had reduced physical performance and lower strength compared to the HC, despite normal muscle mass, suggesting a possible muscle dysfunction. Gait characteristics may be a potential biomarker of interest in axSpA.
本研究旨在比较中轴型脊柱关节炎（axSpA）患者与健康对照组（HC）之间的肌肉物理特性、力量、质量、身体表现和肌少症的患病率。
我们对 54 名参与者进行了一项横断面研究：27 名 axSpA 患者和 27 名 HC，年龄、性别和身体活动水平相匹配。比较两组之间的肌肉物理特性（僵硬、紧张度和弹性）、肌肉力量（五次坐站测试[5STS]）、肌肉质量、身体表现（通过步态速度测量）和肌少症。进行线性回归模型，允许对相关变量进行调整。
axSpA 患者（平均年龄 36.5（7.5）岁，67%为男性，平均病程 6.5（3.2）年）与 HC 相比，节段性肌肉僵硬、紧张度或弹性无显著差异，尽管 L3-L4 下部的僵硬程度略高（中位数 246.5（IQR 230.5-286.5）比 232.5（211.0-293.5），p=0.38）。没有参与者出现肌少症。与 HC 相比，axSpA 患者的总力量较低（B=1.88（95%CI 0.43；3.33）），上肢力量较低（B=-17.02（-27.33；-6.70）），下肢力量较低（B=-11.14（-18.25；-4.04）），这些差异独立于肌肉物理特性。与 HC 相比，患者的步态速度也显著较慢（B=-0.11（-0.21；-0.01）），该结果在调整肌肉质量、力量和肌肉物理特性后仍然成立。
病程相对较短的年轻 axSpA 患者的节段性肌肉物理特性与 HC 相似，且无肌少症。与 HC 相比，axSpA 患者的身体表现和力量降低，尽管肌肉质量正常，提示可能存在肌肉功能障碍。步态特征可能是 axSpA 的一个潜在的有价值的生物标志物。
