INSERM UMR 1033-Université de Lyon, 5 Place d'Arsonval, 69437, Lyon, France.
Service de Rhumatologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, France.
Calcif Tissue Int. 2023 Jun;112(6):647-655. doi: 10.1007/s00223-023-01074-3. Epub 2023 Mar 21.
To evaluate the prevalence of probable, confirmed, and severe sarcopenia in spondyloarthritis (SpA), according to the European Working Group on Sarcopenia in Older People 2019 (EWGSOP2) definition. A total of 103 patients (51% women) with SpA, mean age 47.1 ± 13.7 years, were included and compared to 103 age- and sex-matched controls. Grip strength was measured by dynamometry. Body composition was assessed by whole-body densitometry. In SpA patients gait speed was measured by the 4-m-distance walk test and quality of life was evaluated with a specific health-related questionnaire for sarcopenia (SaRQoL®). Twenty-two SpA patients (21%) versus 7 controls (7%) had a low grip strength, i.e., probable sarcopenia (p < 0.01), 15 SpA (15%) patients and 7 controls (7%) had low Skeletal Muscle mass Index (SMI) (ns), respectively, and 5 and 2% of SpA patients and controls had low grip strength and low SMI, i.e., confirmed sarcopenia (ns). All the sarcopenic SpA patients had a low gait speed, i.e., severe sarcopenia. Finally, probable sarcopenic SpA patients had significantly higher C-Reactive Protein (CRP, p < 0.001) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI score, p < 0.01), lower gait speed (p < 0.001), and SarQoL® score (p < 0.001) than SpA patients with normal grip strength. According to EWGSOP2 definition, the prevalence of probable sarcopenia was significantly higher in SpA patients compared to controls. Probable sarcopenia was associated with higher inflammation and disease activity, impaired muscle performance, and quality of life. These results suggest that muscle strength may be a salient hallmark in SpA.
评估根据欧洲老年人肌肉减少症工作组 2019 年（EWGSOP2）定义的脊柱关节炎（SpA）中可能、确诊和严重肌肉减少症的患病率。共纳入 103 名（51%为女性）SpA 患者，平均年龄 47.1±13.7 岁，并与 103 名年龄和性别匹配的对照进行比较。握力通过测力法测量。身体成分通过全身密度测定法评估。在 SpA 患者中，步态速度通过 4 米距离步行测试测量，生活质量通过特定的肌肉减少症健康相关问卷（SaRQoL®）进行评估。22 名 SpA 患者（21%）与 7 名对照（7%）握力较低，即可能存在肌肉减少症（p<0.01），15 名 SpA 患者（15%）和 7 名对照（7%）的骨骼肌质量指数（SMI）较低（无统计学差异），5%和 2%的 SpA 患者和对照组握力和 SMI 较低，即确诊的肌肉减少症（无统计学差异）。所有肌肉减少症的 SpA 患者步态速度均较低，即严重肌肉减少症。最后，可能存在肌肉减少症的 SpA 患者的 C 反应蛋白（CRP，p<0.001）和 Bath 强直性脊柱炎疾病活动指数（BASDAI 评分，p<0.01）更高，步态速度（p<0.001）和 SaRQoL®评分（p<0.001）更低，而握力正常的 SpA 患者。根据 EWGSOP2 定义，与对照组相比，SpA 患者中可能存在肌肉减少症的患病率显著更高。可能存在肌肉减少症与更高的炎症和疾病活动度、肌肉功能受损和生活质量降低有关。这些结果表明肌肉力量可能是 SpA 的一个显著特征。
