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年轻炎性关节炎患者肌肉减少症的评估:一项横断面研究。

Assessment of sarcopenia in young patients with inflammatory arthritis: a cross-sectional study.

作者信息

Kulyk Myroslava, Dzhus Marta

机构信息

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.

出版信息

Sci Rep. 2025 Mar 10;15(1):8236. doi: 10.1038/s41598-025-88939-9.

Abstract

Sarcopenia is a disease characterized by decreasing muscle mass and strength or performance. The prevalence of sarcopenia in rheumatic diseases has been evaluated in single diseases using various diagnostic approaches, generating conflicting data. The study aims to investigate sarcopenia prevalence in young adults with inflammatory arthritis (IA) and to detect factors associated with low muscle mass and strength. The single-center, cross-sectional study included 138 young adults with IA. Dynamometry with a Jamar hand dynamometer was used to determine handgrip strength. Thresholds for reduced muscle strength were < 27 kg for males and < 16 kg for females. To determine skeletal mass index (SMI), dual photon X-ray absorptiometry (DXA) was done with such cut-off points < 5.67 kg/m in females and < 7.0 kg/m in males. Patients with both reduced muscle mass and strength were considered as sarcopenic. Logistic regression analyses estimated between sarcopenia and associated factors. Statistical significance was defined as a p-value < 0.05. The prevalence of sarcopenia was about 47% in all IA and was significantly different between juvenile idiopathic arthritis (JIA), spondyloarthritis (SpA), and rheumatoid arthritis (RA) groups (p = 0.006). At multivariable analysis, body mass index (BMI) (OR 0.84; CI 95% 0.72-0.86, p = 0.02), bone mineral density (BMD) at femur neck (OR 0.01; CI 95% 0.001-0.268, p = 0.01), 25-hydroxyvitamin D (25(OH)D) (OR 0.96; CI 95% 0.93-0.98, p = 0.001), and disability by Health Assessment Questionnaire (HAQ) (OR 14.54; CI 95% 4.92-51.77, p < 0.001) were associated with a significantly increased risk of sarcopenia. The results of our study demonstrate a high prevalence of sarcopenia among young patients with IA. In these participants, lower BMI, lower BMD, 25(OH)D concentration, and higher HAQ were linked to sarcopenia.

摘要

肌肉减少症是一种以肌肉质量、力量或功能下降为特征的疾病。使用各种诊断方法对单一风湿性疾病中肌肉减少症的患病率进行了评估,得出的数据相互矛盾。本研究旨在调查患有炎性关节炎(IA)的年轻成年人中肌肉减少症的患病率,并检测与低肌肉质量和力量相关的因素。这项单中心横断面研究纳入了138名患有IA的年轻成年人。使用Jamar握力计进行握力测量。男性肌肉力量降低的阈值为<27千克,女性为<16千克。为了确定骨骼肌质量指数(SMI),采用双能X线吸收法(DXA)进行测量,女性的截断点为<5.67千克/米,男性为<7.0千克/米。肌肉质量和力量均降低的患者被视为患有肌肉减少症。采用逻辑回归分析评估肌肉减少症与相关因素之间的关系。统计学显著性定义为p值<0.05。所有IA患者中肌肉减少症的患病率约为47%,在幼年特发性关节炎(JIA)、脊柱关节炎(SpA)和类风湿关节炎(RA)组之间存在显著差异(p = 0.006)。在多变量分析中,体重指数(BMI)(比值比0.84;95%置信区间0.72 - 0.86,p = 0.02)、股骨颈骨密度(BMD)(比值比0.01;95%置信区间0.001 - 0.268,p = 0.01)、25 - 羟基维生素D(25(OH)D)(比值比0.96;95%置信区间0.93 - 0.98,p = 0.001)以及健康评估问卷(HAQ)评估的残疾情况(比值比14.54;95%置信区间4.92 - 51.77,p < 0.001)与肌肉减少症风险显著增加相关。我们的研究结果表明,患有IA的年轻患者中肌肉减少症的患病率很高。在这些参与者中,较低的BMI、较低的BMD、25(OH)D浓度以及较高的HAQ与肌肉减少症有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4249/11893876/7e6562a3b595/41598_2025_88939_Fig1_HTML.jpg

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