Doubek João Gabriel Cavazzani, Kahlow Bárbara S, Nisihara Renato, Skare Thelma L
Mackenzie Evangelical School of Medicine of Paraná, Curitiba, Brazil.
Rheumatology Unit, Hospital Universitário Evangélico Mackenzie, Curitiba, Brazil.
Int J Rheum Dis. 2022 Oct;25(10):1145-1151. doi: 10.1111/1756-185X.14394. Epub 2022 Jul 26.
Patients with rheumatoid arthritis (RA) may have nutritional impairment. In RA, muscle loss is associated with an increase in fat tissue, and the patients may not have body mass index (BMI) alterations.
To study the nutritional status in a sample of patients with RA in Brazil through mini nutritional assessment (MNA) and electric bioimpedance and its relationship to BMI, functionality, disease activity, and treatment.
Seventy-one RA females were included. Chart review was used to obtain epidemiological, clinical, and treatment data. Patients answered the MNA and were submitted to electrical bioimpedance and anthropometric measurements. Disease activity was assessed through simple disease activity index (SDAI), clinical disease activity index (CDAI), and function, through health assessment questionnaire (HAQ).
According to MNA, 23 (32.4%) patients were at risk for malnutrition and 1 (1.4%) was malnourished. MNA were associated with disease activity and function impairment (SDAI P = .02; CDAI P = .02, and HAQ P = .002) but not with used medications. According to BMI, 76% were overweight or obese. An increased percentage of body fat was found in 98.7% and a lower percentage of lean mass in 95.7%. Disease activity and function were not associated with the percentage of body fat of any used medications, with a lower percentage of body fat in those using abatacept (P = .01).
Almost one-third of patients had nutritional impairment according to MNA which was associated with disease activity and loss of function. Almost the whole sample had an increased percentage of fat mass and a diminished percentage of muscle mass that could not be linked with disease activity, function or used medications.
类风湿关节炎（RA）患者可能存在营养障碍。在RA中，肌肉流失与脂肪组织增加有关，且患者的体重指数（BMI）可能无变化。
通过微型营养评定法（MNA）和生物电阻抗分析研究巴西RA患者样本的营养状况及其与BMI、功能、疾病活动度和治疗的关系。
纳入71名女性RA患者。通过查阅病历获取流行病学、临床和治疗数据。患者完成MNA问卷，并接受生物电阻抗分析和人体测量。通过简化疾病活动指数（SDAI）、临床疾病活动指数（CDAI）评估疾病活动度，通过健康评估问卷（HAQ）评估功能。
根据MNA，23名（32.4%）患者存在营养不良风险，1名（1.4%）患者营养不良。MNA与疾病活动度和功能损害相关（SDAI P = 0.02；CDAI P = 0.02，HAQ P = 0.002），但与所用药物无关。根据BMI，76%的患者超重或肥胖。98.7%的患者体脂百分比增加，95.7%的患者瘦体重百分比降低。疾病活动度和功能与任何所用药物的体脂百分比均无关联，但使用阿巴西普的患者体脂百分比更低（P = 0.01）。
根据MNA，近三分之一的患者存在营养障碍，这与疾病活动度和功能丧失有关。几乎整个样本的体脂百分比增加，肌肉质量百分比降低，这与疾病活动度、功能或所用药物无关。
