Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University.
Semin Arthritis Rheum. 2022 Dec;57:152090. doi: 10.1016/j.semarthrit.2022.152090. Epub 2022 Aug 31.
To examine the association between sarcopenia and comorbidities among patients with rheumatoid arthritis (RA).
We selected RA patients and age- and sex-matched non-RA controls at a 1:5 ratio from 2008-2011 Korea National Health and Nutrition Examination Survey database. Sarcopenia was defined by appendicular skeletal muscle mass. After investigating associations between sarcopenia and individual comorbidities among RA patients, we performed a stratified analysis comparing three subgroups (RA/sarcopenia, RA/non-sarcopenia, non-RA/sarcopenia) versus a non-RA/non-sarcopenia subgroup to evaluate interactive as well as independent effects of sarcopenia and RA on comorbidities. Health-related behaviors (exercise, smoking, drinking, and diet) were also examined. The weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for age, sex, and income.
We included 400 RA patients and 2,000 non-RA controls (mean age 57.4 years, 79.6% female). Sarcopenia was observed in 20.5% of RA and 19.3% of non-RA group. Among RA patients, sarcopenia was associated with obesity (OR 2.61, 95% CI 1.42-4.83), dyslipidemia (3.09, 1.37-6.99), diabetes (2.07, 0.99-4.33), chronic obstructive pulmonary disease (18.77, 2.40-146.55), and hepatitis B ever-infection (8.69, 1.15-65.58). Among three stratified subgroups, only a RA/sarcopenia subgroup was associated with such comorbidities, cardiovascular diseases, and depression compared to a non-RA/non-sarcopenia subgroup. Health-related behaviors were comparable between patients with and without sarcopenia.
In this nation-wide cross-sectional study, a wide spectrum of comorbidities were preferentially found among RA patients with sarcopenia than without, suggesting that sarcopenia is significantly associated with RA-related comorbidities. Particular attention should be paid to comorbidities of sarcopenic RA patients.
研究目的在于探讨类风湿关节炎（RA）患者的肌肉减少症与合并症之间的相关性。
我们于 2008 年至 2011 年从韩国国家健康和营养检查调查数据库中以 1:5 的比例选择 RA 患者和年龄及性别匹配的非 RA 对照组。四肢骨骼肌质量定义为肌肉减少症。在调查 RA 患者肌肉减少症与各合并症之间的关系后，我们对三个亚组（RA/肌肉减少症、RA/非肌肉减少症、非 RA/肌肉减少症）与非 RA/非肌肉减少症亚组进行分层分析，以评估肌肉减少症和 RA 对合并症的相互作用及独立影响。同时还对健康相关行为（运动、吸烟、饮酒和饮食）进行了调查。采用加权 logistic 回归调整年龄、性别和收入后估计比值比（OR）和 95%置信区间（CI）。
我们纳入了 400 名 RA 患者和 2000 名非 RA 对照者（平均年龄 57.4 岁，79.6%为女性）。RA 组和非 RA 组的肌肉减少症发生率分别为 20.5%和 19.3%。在 RA 患者中，肌肉减少症与肥胖（OR 2.61，95%CI 1.42-4.83）、血脂异常（3.09，1.37-6.99）、糖尿病（2.07，0.99-4.33）、慢性阻塞性肺疾病（18.77，2.40-146.55）和乙型肝炎既往感染（8.69，1.15-65.58）相关。在三个分层亚组中，只有 RA/肌肉减少症亚组与非 RA/非肌肉减少症亚组相比，与心血管疾病和抑郁症等合并症相关。肌肉减少症患者与非肌肉减少症患者的健康相关行为无差异。
在这项全国性横断面研究中，与非肌肉减少症 RA 患者相比，肌肉减少症 RA 患者存在更广泛的合并症，这表明肌肉减少症与 RA 相关的合并症显著相关。应特别关注肌肉减少症 RA 患者的合并症。
