Li Wan-Jun, Yin Ruo-Yan-Ran, Xia Xiao-Xuan, Xing Qian-Xi, Xu Sheng-Qian
Department of Endocrine Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Sci Rep. 2025 Jul 2;15(1):23068. doi: 10.1038/s41598-025-07378-8.
Myostatin and irisin, the key regulators of muscle metabolism, are myokines secreted by skeletal muscles that significantly influence osteoporosis (OP) and sarcopenia. This study investigated the associations of serum myostatin and irisin levels with sarcopenia and OP prevalence in 182 rheumatoid arthritis (RA) versus 142 healthy controls. RA patients exhibited significantly elevated serum myostatin (P = 0.001) and reduced irisin levels (P = 0.009), with markedly higher rates of myostatin/irisin dysregulation compared to controls (both P < 0.0001). Subgroup analyses revealed that RA patients with sarcopenia had higher myostatin (P = 0.002) and lower irisin (P = 0.003) than RA patients without sarcopenia. Similarly, RA patients with osteoporotic fractures (OPF) showed increased myostatin (P = 0.045) and decreased irisin (P = 0.029) compared to those without OPF. Myostatin levels correlated positively with anti-cyclic citrullinated peptide (anti-CCP) antibodies (P = 0.041) and inversely with body mass index (BMI) (P = 0.003), while irisin levels were negatively associated with C-reactive protein (P = 0.040) and positively linked to skeletal muscle mass index (P = 0.036). Multivariate analyses identified the Sharp score as an independent risk factor for OP (OR = 1.005, 95% CI 1.000-1.010; P = 0.04). For sarcopenia, both Sharp score (OR = 1.008, 95% CI 1.002-1.014; P = 0.013) and elevated myostatin levels (OR = 1.222, 95% CI 1.015-1.472; P = 0.034) were significant risk predictors, whereas higher irisin levels conferred protection (OR = 0.963, 95% CI 0.936-0.990; P = 0.007). Elevated serum myostatin and reduced irisin levels are associated with sarcopenia and OPF in RA patients. Sharp scores are identified as a risk factor for OP in RA patients. Additionally, Sharp scores and elevated myostatin levels serve as risk factors for sarcopenia, while irisin levels act as a protective factor against sarcopenia.
肌肉生长抑制素和鸢尾素是肌肉代谢的关键调节因子，是由骨骼肌分泌的肌动蛋白，对骨质疏松症（OP）和肌肉减少症有显著影响。本研究调查了182例类风湿性关节炎（RA）患者与142例健康对照者血清中肌肉生长抑制素和鸢尾素水平与肌肉减少症和OP患病率之间的关系。RA患者血清肌肉生长抑制素水平显著升高（P = 0.001），鸢尾素水平降低（P = 0.009），与对照组相比，肌肉生长抑制素/鸢尾素失调率明显更高（P均<0.0001）。亚组分析显示，与无肌肉减少症的RA患者相比，患有肌肉减少症的RA患者肌肉生长抑制素水平更高（P = 0.002），鸢尾素水平更低（P = 0.003）。同样，与无骨质疏松性骨折（OPF）的RA患者相比，患有OPF的RA患者肌肉生长抑制素水平升高（P = 0.045），鸢尾素水平降低（P = 0.029）。肌肉生长抑制素水平与抗环瓜氨酸肽（抗CCP）抗体呈正相关（P = 0.041），与体重指数（BMI）呈负相关（P = 0.003），而鸢尾素水平与C反应蛋白呈负相关（P = 0.040），与骨骼肌质量指数呈正相关（P = 0.036）。多因素分析确定Sharp评分是OP的独立危险因素（OR = 1.005，95%CI 1.000-1.010；P = 0.04）。对于肌肉减少症，Sharp评分（OR = 1.008，95%CI 1.002-1.014；P = 0.013）和升高的肌肉生长抑制素水平（OR = 1.222，95%CI 1.015-1.472；P = 0.034）均为显著的风险预测因素，而较高的鸢尾素水平具有保护作用（OR = 0.963，95%CI 0.936-0.990；P = 0.007）。血清肌肉生长抑制素升高和鸢尾素水平降低与RA患者的肌肉减少症和OPF相关。Sharp评分被确定为RA患者OP的危险因素。此外，Sharp评分和升高的肌肉生长抑制素水平是肌肉减少症的危险因素，而鸢尾素水平是预防肌肉减少症的保护因素。
