Internal Medicine Department No 2, Bogomolets National Medical University, 13 Shevchenko boulevard, Kyiv, 03055, Ukraine.
Rheumatology Department, Communal Noncommercial Institution "Oleksandrivska Clinical Hospital", Kyiv, Ukraine.
BMC Musculoskelet Disord. 2024 Nov 18;25(1):923. doi: 10.1186/s12891-024-08051-3.
Sarcopenia is a generalized loss of skeletal muscle mass, strength, and performance, and early identification is crucial to minimize adverse outcomes. While sarcopenia is well-studied in older populations, data on its prevalence and risk factors in young adults with juvenile idiopathic arthritis (JIA) remain limited.
The study aimed to evaluate the prevalence of sarcopenia in young adults with JIA and to identify associated risk factors.
A cross-sectional single-center study was conducted at the Rheumatology Department of Communal Noncommercial Institution "Oleksandrivska Clinical Hospital", Kyiv, Ukraine, involving 70 patients between November 2020 and November 2022. Initially, 84 patients were recruited; however, 14 were excluded due to joint replacement, diabetes, or refusal to participate. Sarcopenia was diagnosed using the Find-Assess-Confirm-Severity algorithm, assessing muscle strength with a dynamometer, confirming sarcopenia using dual-energy X-ray absorptiometry, and determining severity via gait speed tests. Univariable and multivariable logistic regression was used to identify factors associated with sarcopenia and reported as odds ratios (OR) and 95% confidence intervals (95% CI).
Low handgrip strength, sarcopenia, and severe sarcopenia were observed in 64% (45/70), 59% (41/70), and 34% (24/70) of the patients, respectively. Men were less likely to lose muscle mass than women were (OR 0.29, 95% CI 0.10-0.89; p = 0.03). Sarcopenia was significantly predicted by disease activity according to the Disease Activity Score 28 based on erythrocytes sedimentation rate (DAS28-ESR) and clinical Juvenile Arthritis Disease Activity Score (cJADAS27) (OR 2.08, 95% CI 1.15-3.76; p = 0.01; OR 1.15, 95% CI 1.04-1.27; p = 0.007, respectively), articular and extra-articular Juvenile Arthritis Damage Index (JADI) (JADI-A OR 2.29, 95% CI 1.23-4.25; p = 0.009; JADI-E OR 3.15, 95% CI 1.36-7.29; p = 0.008, respectively), and functional capacity according to the Health Assessment Questionnaire (OR 4.14, 95% CI 1.38-12.5; p = 0.01).
Sarcopenia in young adults with JIA was associated with disease activity (measured by DAS28-ESR and cJADAS27), articular and extra-articular damage (measured by JADI indices), and lower functional capacity.
肌肉减少症是一种骨骼肌质量、力量和功能的普遍丧失，早期识别对于最大限度地减少不良后果至关重要。虽然肌肉减少症在老年人群中研究得较多，但关于青少年特发性关节炎（JIA）患者中肌肉减少症的患病率和风险因素的数据仍然有限。
本研究旨在评估 JIA 年轻患者中肌肉减少症的患病率，并确定相关的风险因素。
这是一项在乌克兰基辅的 Communal Noncommercial Institution "Oleksandrivska Clinical Hospital" 的风湿病科进行的横断面单中心研究，纳入了 2020 年 11 月至 2022 年 11 月期间的 70 名患者。最初招募了 84 名患者，但由于关节置换、糖尿病或拒绝参与，有 14 名患者被排除在外。使用 Find-Assess-Confirm-Severity 算法诊断肌肉减少症，使用测力计评估肌肉力量，使用双能 X 线吸收法确认肌肉减少症，并通过步态速度测试确定严重程度。使用单变量和多变量逻辑回归来识别与肌肉减少症相关的因素，并以比值比（OR）和 95%置信区间（95%CI）表示。
在 70 名患者中，64%（45/70）、59%（41/70）和 34%（24/70）的患者分别存在低握力、肌肉减少症和严重肌肉减少症。与女性相比，男性更不容易失去肌肉质量（OR 0.29，95%CI 0.10-0.89；p=0.03）。肌肉减少症与疾病活动度显著相关，疾病活动度根据红细胞沉降率（DAS28-ESR）和临床青少年关节炎疾病活动度评分（cJADAS27）评估（OR 2.08，95%CI 1.15-3.76；p=0.01；OR 1.15，95%CI 1.04-1.27；p=0.007），与关节和关节外青少年关节炎损害指数（JADI）评估（JADI-A OR 2.29，95%CI 1.23-4.25；p=0.009；JADI-E OR 3.15，95%CI 1.36-7.29；p=0.008），以及与健康评估问卷（HAQ）评估的功能能力（OR 4.14，95%CI 1.38-12.5；p=0.01）相关。
JIA 年轻患者的肌肉减少症与疾病活动度（通过 DAS28-ESR 和 cJADAS27 测量）、关节和关节外损害（通过 JADI 指数测量）以及较低的功能能力相关。
