Instituto de Investigación Biomédica de Málaga (IBIMA)-Plataforma Bionand, 29010 Málaga, Spain.
UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain.
Nutrients. 2023 May 24;15(11):2440. doi: 10.3390/nu15112440.
To describe the prevalence of sarcopenia in rheumatoid arthritis (RA) patients aged ≥65 years and identify the risk factors associated with sarcopenia.
This is a multicenter, controlled, cross-sectional study of 76 RA patients and 76 age- and sex-matched healthy controls. Sarcopenia was defined according to the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Whole-body dual-energy X-ray absorptiometry (DXA) was performed. Binary regression was used to assess the relationship between sarcopenia and sex, age, duration of RA, Mini Nutritional Assessment (MNA) score, and Short Physical Performance Battery (SPPB) score in patients with RA.
Nearly 80% of participants were female, and the average age was >70 years. Patients with RA had lower muscle mass and greater adiposity (fat-to-muscle ratio mean [SD] 0.9 [0.2] vs. 0.8 [0.2]; = 0.017) than controls, mainly in the central area (android/gynoid ratio, median [p25-p75]: 1.0 [0.9-1.2] vs. 0.9 [0.8-1.1]; < 0.001). Twelve patients (15.8%) and three controls (3.9%) had confirmed sarcopenia ( = 0.014). Sarcopenic obesity was observed in 8/76 patients with RA (10.5%) and in 1/76 controls (1.3%) ( = 0.016). The factors associated with sarcopenia were male sex (OR [95% CI]: 9.3 [1.1-80.4]; = 0.042), disease duration (OR [95% CI]: 1.1 [1.0-1.2]; = 0.012), and nutritional status according to the MNA (OR [95% CI]: 0.7 [0.5-0.9]; = 0.042).
Our results suggest that patients with RA aged ≥65 years may be at increased risk for sarcopenia, adiposity, and malnutrition (especially male patients with long-standing disease) and have poor nutritional status.
描述 65 岁及以上类风湿关节炎（RA）患者中肌少症的患病率，并确定与肌少症相关的危险因素。
这是一项多中心、对照、横断面研究，纳入 76 例 RA 患者和 76 名年龄和性别匹配的健康对照者。根据欧洲老年人肌少症工作组（EWGSOP2）修订标准定义肌少症。对所有参与者进行全身双能 X 线吸收法（DXA）检查。采用二元回归分析评估 RA 患者中肌少症与性别、年龄、RA 病程、微型营养评估（MNA）评分和简易体能状况量表（SPPB）评分之间的关系。
近 80%的参与者为女性，平均年龄＞70 岁。与对照组相比，RA 患者的肌肉量较低，体脂较多（脂肪-肌肉比均值[SD]：0.9[0.2]比 0.8[0.2]； = 0.017），主要集中在中央区域（男性型/女性型比值中位数[25%75%]：1.0[0.91.2]比 0.9[0.81.1]； ＜0.001）。12 例（15.8%）患者和 3 例（3.9%）对照者存在确诊肌少症（ = 0.014）。8 例 RA 患者（10.5%）和 1 例对照者（1.3%）出现肌少性肥胖（ = 0.016）。与肌少症相关的因素为男性（比值比[95%CI]：9.3[1.180.4]； = 0.042）、病程（比值比[95%CI]：1.1[1.01.2]； = 0.012）和根据 MNA 评估的营养状态（比值比[95%CI]：0.7[0.50.9]； = 0.042）。
本研究结果表明，65 岁及以上 RA 患者可能存在肌少症、肥胖和营养不良（尤其是病程较长的男性患者）的风险，且营养状态较差。
