Kanjanavaikoon Natnicha, Saisirivechakun Pannarat, Chaiamnuay Sumapa
Department of Internal Medicine, Krathumbaen Hospital, Samut Sakhon, Thailand.
Department of Internal Medicine, Nakhon Pathom Hospital, Nakhon Pathom, Thailand.
Clin Rheumatol. 2023 Dec;42(12):3257-3265. doi: 10.1007/s10067-023-06770-x. Epub 2023 Sep 27.
BACKGROUND/OBJECTIVE: Sarcopenia is characterized by a decline in muscle strength, muscle mass, and physical performance. Persistent inflammation may lead to muscle wasting. This research aims to determine the prevalence and associated factors of sarcopenia in axial spondyloarthritis (ax-SpA).
A cross-sectional study of 104 ax-SpA patients who met the 2009 ASAS criteria was conducted at Phramongkutklao Hospital between January 2020 and February 2021. Sarcopenia-related factors and disease characteristics were recorded. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Strength, ambulation, rising from a chair, stair climbing and history of falling (SARC-F) was evaluated. Muscle strength was measured by hand grip strength and chair stand time. Physical performance was assessed by 6-m walk and time up and go tests. Logistic regression was performed to identify factors associated with sarcopenia.
Most patients were male (74%), with a mean (standard deviation, SD) age and disease duration of 42.6 (12.2) and 8.3 (8.5) years, respectively. The mean BMI (SD) was 23.8 (4.4). The prevalence of sarcopenia was 22.1%. There were no differences in disease activity (BASDAI and ASDAS) between ax-SpA patients with and without sarcopenia. Age, low BMI, and BASFI score were independently associated with sarcopenia, with adjusted odds ratios and 95% confidence intervals of 1.08 (1.01-1.16), 0.39 (0.25-0.63), and 1.41 (1.07-1.86), respectively.
Sarcopenia is common in ax-SpA patients and is independently associated with older age, low BMI, and high BASFI score but not disease activity. Key Points • Despite the fact that ax-SpA patients are typically young, sarcopenia is frequently observed within this population. • Sarcopenia in ax-SpA patients has an independent association with older age, low BMI, and functional limitations (high BASFI scores). • Sarcopenia in ax-SpA patients is not associated with disease activity; however, early treatment to prevent functional limitations may prevent sarcopenia in ax-SpA patients.
背景/目的：肌少症的特征是肌肉力量、肌肉质量和身体功能下降。持续性炎症可能导致肌肉萎缩。本研究旨在确定轴性脊柱关节炎（ax-SpA）患者中肌少症的患病率及其相关因素。
于2020年1月至2021年2月在诗里蒙坤贴医院对104例符合2009年ASAS标准的ax-SpA患者进行了一项横断面研究。记录与肌少症相关的因素和疾病特征。根据2019年亚洲肌少症工作组的标准诊断肌少症。采用双能X线吸收法测量四肢骨骼肌质量。评估力量、行走、从椅子上起身、爬楼梯及跌倒史（SARC-F）。通过握力和从椅子上站起的时间测量肌肉力量。通过6米步行和计时起立行走测试评估身体功能。进行逻辑回归分析以确定与肌少症相关的因素。
大多数患者为男性（74%），平均（标准差，SD）年龄和病程分别为42.6（12.2）岁和8.3（8.5）年。平均体重指数（SD）为23.8（4.4）。肌少症的患病率为22.1%。有肌少症和无肌少症的ax-SpA患者在疾病活动度（BASDAI和ASDAS）方面无差异。年龄、低体重指数和BASFI评分与肌少症独立相关，调整后的比值比和95%置信区间分别为1.08（1.01 - 1.16）、0.39（0.25 - 0.63）和1.41（1.07 - 1.86）。
肌少症在ax-SpA患者中很常见，且与年龄较大、低体重指数和高BASFI评分独立相关，但与疾病活动度无关。要点 • 尽管ax-SpA患者通常较为年轻，但该人群中经常观察到肌少症。 • ax-SpA患者的肌少症与年龄较大、低体重指数和功能受限（高BASFI评分）独立相关。 • ax-SpA患者的肌少症与疾病活动度无关；然而，早期治疗以预防功能受限可能预防ax-SpA患者发生肌少症。
