Objective

Rheumatoid cachexia (RC) is prevalent among patients with established rheumatoid arthritis (RA). Although changes in muscle mass and fat mass have been reported in early RA, these findings have not been classified according to existing RC definitions. This study aimed to describe the prevalence of RC and associated variables in patients with early RA.

Method

This cross-sectional study included 87 patients. Body composition was evaluated with dual-energy X-ray absorptiometry after a median disease duration of 15 months. RC was defined as a fat-free mass index < 10th percentile and fat mass index > 25th percentile. We also assessed the erythrocyte sedimentation rate (ESR), C-reactive protein, Disease Activity Score in 28 joints, aerobic capacity, physical activity, traditional cardiovascular disease risk factors, functional disability, and sociodemographic data. Associations between RC and the independent variables were determined with logistic regression analyses.

Results

The prevalence of RC was 24%. RC was significantly associated [odds ratio (95% confidence interval)] with aerobic capacity [0.28 (0.09–0.89), p = 0.030], low-intensity physical activity [0.77 (0.60–0.99), p = 0.048], body mass index [0.78 (0.70–0.92), p = 0.002], waist circumference [0.96 (0.92–0.99), p = 0.023], body weight [0.94 (0.90–0.98), p = 0.004], and ESR at the time of diagnosis [1.02 (1.00–1.05), p = 0.033]. All of these associations remained significant after adjusting for age and gender.

Conclusion

RC was highly prevalent in early RA. Patient outcome may be improved by detecting this condition early and applying treatments for improving inflammation, aerobic capacity, physical activity, and body composition.

中文翻译：

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类风湿性关节炎早期的类风湿性恶病质：患病率和相关变量

客观的

类风湿性恶病质 (RC) 在患有类风湿性关节炎 (RA) 的患者中很普遍。尽管在早期 RA 中已经报道了肌肉量和脂肪量的变化，但这些发现尚未根据现有的 RC 定义进行分类。本研究旨在描述早期 RA 患者 RC 的患病率和相关变量。

方法

这项横断面研究包括 87 名患者。在中位疾病持续时间为 15 个月后，使用双能 X 射线吸收测定法评估身体成分。RC 定义为去脂质量指数 < 第 10 个百分位和脂肪质量指数 > 第 25 个百分位。我们还评估了红细胞沉降率 (ESR)、C 反应蛋白、28 个关节的疾病活动评分、有氧能力、体力活动、传统心血管疾病危险因素、功能障碍和社会人口统计学数据。RC 和自变量之间的关联通过逻辑回归分析确定。

结果

RC 的患病率为 24%。RC 与有氧运动能力 [0.28 (0.09–0.89)，p = 0.030]，低强度体育活动 [0.77 (0.60–0.99)，p = 0.048]，体重显着相关 [比值比（95% 置信区间）]指数 [0.78 (0.70–0.92)，p = 0.002]，腰围 [0.96 (0.92–0.99)，p = 0.023]，体重 [0.94 (0.90–0.98)，p = 0.004]，ESR 在诊断 [1.02 (1.00–1.05)，p = 0.033]。在调整年龄和性别后，所有这些关联仍然很重要。

结论

RC 在早期 RA 中非常普遍。通过及早发现这种情况并应用改善炎症、有氧能力、身体活动和身体成分的治疗，可以改善患者的预后。