Abnormal body composition phenotypes in older rheumatoid arthritis patients: Association with disease characteristics and pharmacotherapies

Abstract

Objective. To compare measures of body fat and lean mass and the prevalence of abnormal body composition phenotypes (sarcopenia, overfat, and sarcopenic obesity) in men and women with rheumatoid arthritis (RA) versus matched controls, and to explore the disease-related predictors of abnormal body composition in patients with RA. Methods. A total of 189 men and women with RA and 189 age-, sex-, and race-matched non-RA controls underwent dual-energy x-ray absorptiometry for measurement of total and regional body fat and lean mass. Continuous and categorical measures of body composition were compared between RA and control subjects by sex and according to categories of body mass index (BMI). Within the group of RA patients, demographic, lifestyle, and RA disease and treatment characteristics were compared for RA patients with healthy body composition versus those with abnormal body composition phenotypes. Results. Compared with non-RA controls, RA status was significantly associated with greater odds of sarcopenia, overfat, and sarcopenic obesity in women, but not in men. Relative differences in body composition phenotypes between RA and control subjects were greatest for patients in the normal weight BMI category (<25 kg/m 2 ). Among RA characteristics, increasing joint deformity, self-reported disability scores, C-reactive protein levels, rheumatoid factor seropositivity, and a lack of current treatment with disease-modifying antirheumatic drugs were significantly associated with abnormal body composition. Conclusion. Abnormal body composition phenotypes are overrepresented in patients with RA, particularly in those in the normal weight BMI range. RA-associated disease and treatment characteristics contribute to this increase in abnormal body composition.

Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: A long‐term followup from disease onset

“…On the other hand, patients with RA have higher percentages of fat mass compared to healthy controls, and this increase of fat mass can be undetected because it often coincides with a decrease of muscle mass and thus normal BMI (12,21). BMI is therefore not a good marker of body fat content because it does not distinguish between the tissues that comprise it.…”

Presarcopenia and its Impact on Disability in Female Patients With Rheumatoid Arthritis

“…2 In previous studies, abnormalities in body composition (sarcopenia, overfat, and sarcopenic obesity) were reported to be greater in patients with RA than controls. 16 The adipose tissue is known as a producer of several pro-inflammatory cytokines, such as tumor necrosis factor-alpha, interleukin-6, and interleukin-1, all of which are associated with aging, obesity, and low muscle mass. 5 In our study, we could not demonstrate any significant relationship between muscle mass and disease characteristics, including disease duration, pain evaluation, morning stiffness duration, disease activity, and ages of the patients.…”

Sarcopenia in women with rheumatoid arthritis

“…Decreased lean mass, extreme term "sarcopenia, " and increased fat are indicators of poor health in the general population. Loss of lean mass causes weakness, disability, and metabolic abnormalities (2). In most studies, body mass index (BMI), an index that evaluates body weight according to height, has been used as representative of BC.…”

“…In their cross-sectional analysis, Giles et al (29) reported that DMARD treatment alone, biologic or not, is associated with a reduction in the risk of abnormal BC. In our study, no association was found between steroid, DMARD, and biological agent use and sarcopenia development.…”