Toufik Hamza, Ouardi Najlae El, Ghassem Mohamed Ahmed, Djossou Julien H, Taoubane Laila, Majjad Abderrahim, Maghraoui Abdellah El, Bezza Ahmed
Rheumatology Department, Military Hospital Mohammed V, Rabat, Morocco.
Cabinet of Rheumatology, Rabat, Morocco.
Mediterr J Rheumatol. 2023 Aug 25;34(4):506-512. doi: 10.31138/mjr.250823.cpp. eCollection 2023 Dec.
To assess body composition in women with rheumatoid arthritis (RA) compared to healthy controls, to calculate the prevalence of rheumatoid Cachexia (RC), and to identify the associated factors.
We conducted a case-control study on 112 female patients with RA according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA; and 224 age-matched healthy women. Body composition (BC) and bone mineral density (BMD) scans were obtained using Dual-energy X-ray absorptiometry (DXA). RC was defined by a fat-free mass index (FFMI) below the 10 percentile and a fat mass index (FMI) above the 25 percentile compared with the control group. We conducted a comparison between RA patients and healthy controls then a multiple regression analysis was conducted where the dependant variable is the presence of RC.
RC prevalence was 42.85% while the mean body mass index (BMI) was the same in both groups. RA patients had a higher FM and lower FFM comparing to healthy controls. In our population, 78.60% of patients were on methotrexate and 12.50% on anti TNF therapy. Comparison between patients with and without RC showed that patients with RC have a higher proportion of erosive arthritis and of active disease. Regression logistic analysis showed that RC was significantly associated to erosive arthritis and active disease (OR at 33.31 (8.42-131.70) and 8.98 (1.64-49.20) respectively), independently of age, erythrocyte sedimentation rate, C-reactive protein, disease duration, steroid cumulative dose and biologic Disease-Modifying Anti-Rheumatic Drugs(bDMARDs) use.
Our study showed that almost half of our RA patients have RC, even with a high BMI.
评估类风湿关节炎（RA）女性患者与健康对照者的身体成分，计算类风湿恶病质（RC）的患病率，并确定相关因素。
我们根据2010年美国风湿病学会/欧洲抗风湿病联盟RA分类标准，对112例女性RA患者和224例年龄匹配的健康女性进行了病例对照研究。使用双能X线吸收法（DXA）获得身体成分（BC）和骨密度（BMD）扫描结果。与对照组相比，RC定义为无脂肪质量指数（FFMI）低于第10百分位数且脂肪质量指数（FMI）高于第25百分位数。我们对RA患者和健康对照者进行了比较，然后进行了多元回归分析，其中因变量是RC的存在情况。
RC患病率为42.85%，而两组的平均体重指数（BMI）相同。与健康对照者相比，RA患者的脂肪量（FM）较高，无脂肪量（FFM）较低。在我们的研究人群中，78.60%的患者使用甲氨蝶呤，12.50%的患者使用抗TNF治疗。有RC和无RC患者之间的比较表明，有RC的患者侵蚀性关节炎和活动性疾病的比例更高。回归逻辑分析表明，RC与侵蚀性关节炎和活动性疾病显著相关（OR分别为33.31（8.42 - 131.70）和8.98（1.64 - 49.20）），独立于年龄、红细胞沉降率、C反应蛋白、疾病持续时间、类固醇累积剂量和生物性改善病情抗风湿药物（bDMARDs）的使用。
我们的研究表明，即使BMI较高，几乎一半的RA患者仍患有RC。
