Changes to Body Composition in Women With Long-Standing Established Rheumatoid Arthritis: Differences by Level of Disease Activity

Carvalho, Gabriela Dantas; Bonfiglioli, Karina Rossi; Caparbo, Valéria F.; Takayama, Liliam; Pereira, Rosa Maria Rodrigues; Domiciano, Diogo Souza

doi:10.1016/j.jocd.2019.06.002

Cited by 11 publications

(4 citation statements)

References 26 publications

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“…Associations were no longer significant after adjustment for BMI or weight, suggesting that VAT might not have a substantial effect on the skeleton metabolism independent of BMI or mechanical loading 10 . Nonetheless, in patients with RA, moderate inflammatory activity was associated with greater visceral adipose tissue 17 . Whether visceral adiposity measured using CVAI in patients with RA may predict accelerated intra-articular and periarticular bone loss in patients remains for our exploration.…”

Section: Introductionmentioning

confidence: 89%

A novel visceral adiposity index predicts bone loss in female early rheumatoid arthritis patients detected by HR-pQCT

Yue

Wong

Zhang

et al. 2023

Sci Rep

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The purpose of this prospective study is to compare the Chinese visceral adiposity index (CVAI) between early rheumatoid arthritis (ERA) patients and healthy controls; and to assess the relationship between CVAI and the bone microstructure using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ERA patients. 104 female ERA and 100 age-, gender- and BMI-matched healthy controls were recruited for the comparison of CVAI. All ERA patients were prospectively followed for 1 year. HR-pQCT scan of the distal radius, tibia and second metacarpal head were performed at baseline and after one-year. ERA patients were divided into two sub-groups according to the median CVAI value (65.73) (low CVAI and high CVAI groups). CVAI in the ERA group was significantly higher than the controls group (p = 0.01). At baseline, the high CVAI group had a higher ESR level (p = 0.004) while the cortical volumetric bone mineral density (vBMD) was lower (at both the distal radius and tibia, all p < 0.05) compared to the low CVAI group. Linear regression analysis revealed that a higher baseline CVAI was an independent predictor of a lower cortical vBMD at month 12 (distal radius: B = − 0.626, p = 0.022, 95%CI − 1.914 to − 0.153; tibia: B = − 0.394, p = 0.003, 95%CI − 1.366 to − 0.290); and a greater reduction in trabecular vBMD (tibia: B = 0.444, p = 0.001, 95%CI 0.018–0.063; distal radius: B = 0.356, p = 0.008, 95%CI 0.403–0.063). In summary, CVAI is an independent predictor of trabecular bone loss in female patients with ERA, which may be augmented by a chronic inflammatory state in patients with visceral dysfunction of fat metabolism.Trial registration:http://Clinicaltrial.gov no: NCT01768923, 16/01/2013.

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Section: Introductionmentioning

confidence: 89%

A novel visceral adiposity index predicts bone loss in female early rheumatoid arthritis patients detected by HR-pQCT

Yue

Wong

Zhang

et al. 2023

Sci Rep

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“…In a longitudinal study of 294 RA patients, Park et al [ 36 ] showed that sarcopenia (defined by SMI) has a prognostic value for increased disease activity (DAS28-ESR) at 3 years (OR = 4.477; 95% CI 1.661–12.067; p = 0.003). Another cross-sectional study in women with RA observed an association between inflammation levels and long-standing RA (CRP levels) and muscle mass (ALMI) [ 37 ]. In a case–control study, Reina et al [ 30 ] found that BMI, SMI, and lean appendicular mass are inversely correlated, and that fat mass is directly correlated with disease duration in patients with RA, in both men and women.…”

Section: Sarcopenia and Immuno-mediated Rheumatic Diseasesmentioning

confidence: 99%

Sarcopenia, immune-mediated rheumatic diseases, and nutritional interventions

et al. 2021

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Introduction Sarcopenia is defined by a loss of muscle mass and function associated with mortality, decreased physical performance, falls, and disability. Since chronic inflammation and decreased physical activity are risk factors for developing sarcopenia, it is critical to assess the role of sarcopenia in immune-mediated rheumatic diseases (IMRDs). Moreover, nutritional interventions are emerging as key modifiable and affordable options to improve physical performance in sarcopenia. Objective The aim of this review is to critically summarize current information on the evidence linking nutritional interventions and sarcopenia in IMRDs. Methods The search and selection of articles was performed in Medline, Dimensions.ai, Google Scholar, Cochrane Library, Epistemonikos, and Trip Database. The results were clustered into three areas: sarcopenia and IMRDs, sarcopenia and biological disease-modifying antirheumatic drugs (bDMARDs), and nutritional interventions for sarcopenia. Findings Several cross-sectional studies have shown a higher prevalence of sarcopenia in IMRDs, such as rheumatoid arthritis. Although not fully established, evidence linking sarcopenia and other IMRDs (ankylosing spondylitis and systemic sclerosis) has been also described. For secondary sarcopenia prevention and treatment, bDMARDs’ administration proved efficacy in patients with rheumatoid arthritis. Furthermore, there is growing evidence linking nutrition to the prevention and treatment of sarcopenia. Evidence linking unfavourable results in nutritional risk assessment, insufficient intake of protein, vitamin D, antioxidant nutrients, and long-chain polyunsaturated fatty acids and sarcopenia have been reported. Conclusion Given that sarcopenia and IMRDs have strong links, further research is needed to improve patient care.

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“…A recent meta-analysis showed a prevalence of rheumatoid cachexia of 15-32%, according to different diagnostic criteria [99]. Utilization of dual-energy X-ray absorptiometry to evaluate visceral adipose tissue has shown that chronic, high inflammatory activity is associated with both lower muscle and fat mass (including visceral adipose tissue), while moderate inflammatory activity is associated with greater visceral adipose tissue, which is associated with increased CV risk [100].…”

Section: Ra Weight and Body Compositionmentioning

confidence: 99%

Understanding the Role of Interleukin-6 (IL-6) in the Joint and Beyond: A Comprehensive Review of IL-6 Inhibition for the Management of Rheumatoid Arthritis

Favalli

2020

Rheumatol Ther

100

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Rheumatoid arthritis (RA) is a chronic, debilitating autoimmune disorder involving inflammation and progressive destruction of the joints, affecting up to 1% of the population. The majority of patients with RA have one or more comorbid conditions, the most common being cardiovascular disease, osteoporosis, and depression, the presence of which are associated with poorer clinical outcomes and lower healthrelated quality of life. RA pathogenesis is driven by a complex network of proinflammatory cells and cytokines, and of these, interleukin-6 (IL-6) plays a key role in the chronic inflammation associated with RA. Through cell signaling that can be initiated by both membrane-bound and soluble forms of its receptor, IL-6 acts both locally to promote joint inflammation and destruction, and in the circulation to mediate extra-articular manifestations of RA, including pain, fatigue, morning stiffness, anemia, and weight loss. This narrative review describes the role of IL-6 in the pathogenesis of RA, its comorbidities, and extra-articular systemic manifestations, and examines the effects of the IL-6 receptor inhibitors sarilumab and tocilizumab on clinical endpoints of RA, patient-reported outcomes, and common comorbidities and extra-articular manifestations.

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Changes to Body Composition in Women With Long-Standing Established Rheumatoid Arthritis: Differences by Level of Disease Activity

Cited by 11 publications

References 26 publications

A novel visceral adiposity index predicts bone loss in female early rheumatoid arthritis patients detected by HR-pQCT

A novel visceral adiposity index predicts bone loss in female early rheumatoid arthritis patients detected by HR-pQCT

Sarcopenia, immune-mediated rheumatic diseases, and nutritional interventions

Understanding the Role of Interleukin-6 (IL-6) in the Joint and Beyond: A Comprehensive Review of IL-6 Inhibition for the Management of Rheumatoid Arthritis

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