Prevalence of sarcopenia in patients with rheumatoid arthritis: association with disease course
Shevchuk S.V.1,2, Poberezhets A.O.1,2
- 1National Pirogov Memorial Medical University, Vinnytsya
- 2«University Clinic» of Vinnytsia National Medical University named after M.I. Pirogov (medical, educational and scientific center)
Summary. Sarcopenia is a common comorbid condition in patients with rheumatoid arthritis (RA), leading to reduced physical performance, more frequent hospitalisations and a worse prognosis. At the same time, data on the prevalence of presarcopenia, sarcopenia and severe sarcopenia, as well as their relationship with the course of RA, remain unclear. The objective: to study the prevalence of presarcopenia, sarcopenia and severe sarcopenia in patients with RA and to assess their relationship with the course of the disease. Materials and methods. We examined 120 patients with RA (98 women and 22 men) with a mean age of 55.2±11.8 years and a mean disease duration of 12.0±8.3 years. The control group included of 30 practically healthy individuals representative in terms of age and gender. The diagnosis of RA was established according to the ACR/EULAR criteria (2010). The assessment of skeletal muscle state was performed according to the F-A-C-S algorithm according to the criteria of the European Working Group on Sarcopenia in Older People using the SARC-F questionnaire, handgrip strength, the ‘stand up from a chair’ test, dual-energy X-ray absorptiometry, and the gait speed test. Disease activity was assessed using the DAS-28, CDAI and SDAI indices, as well as ESR and C-reactive protein levels. Results. In patients with RA, comorbid skeletal muscle damage was significantly more common than in the control group. In particular, presarcopenia, sarcopenia, including severe sarcopenia were found in 47.5% and 24.2% of patients, respectively (p<0.05). The prevalence of sarcopenia increased with age, disease duration, RA seropositive status, progression of the radiographic stage, and higher inflammatory activity. The proportion of patients with sarcopenia (including severe sarcopenia) was highest in patients with high RA activity and was 71.4%, 66.7%, 85.7% respectively according to DAS-28, CDAI, and SDAI. Conclusions. Skeletal muscle damage of various degrees of severity is more common among patients with RA than in the control group and is closely associated with the course of the disease.
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