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

Abstract

Objectives:This cross-sectional pilot study aims to investigate presarcopenia in female patients with rheumatoid arthritis (RA) and to evaluate its relationship to the disability assessment. Patients and methods: Forty female patients with RA (mean age 48.3±8.3; range 31 to 66 years) and 40 healthy controls (mean age 46.2±6.9; range 31 to 58 years) matched for age, sex, and body mass index were included. Pain, morning stiffness duration, disease activity score, erythrocyte sedimentation rate, C-reactive protein, and Health Assessment Questionnaire (HAQ) were evaluated. Body compositions were assessed with whole body dual energy X-ray absorptiometry. The appendicular skeletal muscle mass and skeletal muscle mass index (SMI) of RA patients were compared to the controls and possible correlations between SMI, disease characteristics, and HAQ score were investigated. Results: The body mass index values and percentages of obese, overweight, and healthy weight subjects were similar in the patient and control groups. However, appendicular skeletal muscle mass and SMI calculations were significantly lower, and the percentage of presarcopenia was significantly higher in patients with RA (20%) than controls (7%) (p<0.05). Although there was no significant correlation between SMI and other parameters, a significant negative correlation was determined between SMI and HAQ score in patients with RA (p<0.05). Conclusion:We demonstrated lower SMI values and higher presarcopenia ratios in patients with RA than healthy controls. Independent from other disease characteristics, the inverse correlation between SMI and HAQ scores may contribute to understanding of the impact of the process on patient disability.

Treatment Failure with combined csDMARDs increases the risk of Low Muscle Mass in women with Rheumatoid Arthritis: a cross-sectional study

“…Torii et al (12) described a higher prevalence of low muscle mass in RA patients (49%) in Japan, and similar findings were also found by two independent studies performed in RA patients from Morocco and Turkey (39.8% and 43.3%, respectively) (13,8). However, the rate of low skeletal muscle mass observed in our patients with RA was lower (27.8%), closer to that found in studies performed in Europe and in the United States, in which the reported rates of low muscle mass vary from 20% to 28.6% (7,10). An even lower prevalence of low muscle mass in RA has been reported in two additional studies, one of which was performed in Spain and the second of which was reported in the United States (13% and 11%, respectively) (9, 11).…”

“…Our findings of a higher prevalence of low muscle mass in women with RA compared with controls are consistent with the data reported by other case-control studies. A similar result was identified by Alkan et al in Turkey with a rate of low muscle mass of 20% in their patients with RA versus 7% in their controls(7).Several studies have also compared the frequency of low skeletal muscle mass in RA patients with controls (6, 8-10). Delgado-Frias et al in Spain described a frequency of low muscle mass of 13% in RA patients compared to 6% in controls (9), whereas Tournadre et al in France identified a frequency of low muscle mass of 28.6% in RA patients but only in 4.8% in their controls(10).…”

“…Although the majority of the studies performed in RA patients conclude that the frequency of low skeletal muscle mass is higher than that observed in controls (6)(7)(8)(9)(10),the prevalence rates of myopenia in RA vary widely from 11% to 49% (11,12). A deteriorated skeletal muscle mass should be detected early and treated adequately in RA patients because low muscle mass may be associated with muscle weakness, impairment of functioning, and deteriorated health-related quality of life, among other adverse consequences (13,14,5).…”

Sarcopenia in Patients with Rheumatic Diseases: Prevalence and Associated Risk Factors

“…The diagnosis of sarcopenia was performed in the presence of both muscle mass and muscle strength reduction, while muscle mass reduction alone without muscle strength impairment was considered presarcopenia [1,18]. The reference values for the diagnosis of muscle mass and muscle strength reduction were: MMI < 6.75 kg/m 2 in women and <10.75 kg/m 2 in men (associated with physical disability in subjects aged ≥60 years) and handgrip strength <20 kg in women and <30 kg in men (associated to reduced mobility), respectively [19,20].…”

An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: A cross-sectional analysis

“…Older people can be classified into three stages: robust, pre-sarcopenia (i.e., decrease in muscle mass, but not in gait speed or grip strength), and sarcopenia. Pre-sarcopenia is the stage of shift from robust to sarcopenia [20]. Previous studies have shown that people who are not considered to have sarcopenia because of preserved grip strength also have an increased risk for adverse outcomes [2].…”