Rheumatoid arthritis and nutritional profile: A study in Brazilian females

Abstract

Background: Patients with rheumatoid arthritis (RA) may have nutritional impairment.In RA, muscle loss is associated with an increase in fat tissue, and the patients may not have body mass index (BMI) alterations. Aim:To study the nutritional status in a sample of patients with RA in Brazil through mini nutritional assessment (MNA) and electric bioimpedance and its relationship to BMI, functionality, disease activity, and treatment.Methods: Seventy-one RA females were included. Chart review was used to obtain epidemiological, clinical, and treatment data. Patients answered the MNA and were submitted to electrical bioimpedance and anthropometric measurements. Disease activity was assessed through simple disease activity index (SDAI), clinical disease activity index (CDAI), and function, through health assessment questionnaire (HAQ).Results: According to MNA, 23 (32.4%) patients were at risk for malnutrition and 1(1.4%) was malnourished. MNA were associated with disease activity and function impairment (SDAI P = .02; CDAI P = .02, and HAQ P = .002) but not with used medications. According to BMI, 76% were overweight or obese. An increased percentage of body fat was found in 98.7% and a lower percentage of lean mass in 95.7%. Disease activity and function were not associated with the percentage of body fat of any used medications, with a lower percentage of body fat in those using abatacept (P = .01). Conclusion:Almost one-third of patients had nutritional impairment according to MNA which was associated with disease activity and loss of function. Almost the whole sample had an increased percentage of fat mass and a diminished percentage of muscle mass that could not be linked with disease activity, function or used medications. K E Y W O R D Snutrition, obesity, rheumatoid arthritis Rheumatoid arthritis (RA) is a chronic autoimmune disease with profound repercussions on the patient's quality of life. Chronic pain, stiffness, fatigue, and disability bring isolation, unemployment, and economic losses, are some of the consequences of a long-term disease. 1 Furthermore, RA patients' survival may be reduced due to lung impairment, 2,3 infections, and cardiovascular diseases associated with accelerated atherosclerosis. 4 The nutrition of these patients is also affected, which may make the disease even more dangerous and kill more people. 1,5 Cachexia in RA or rheumatoid cachexia is different from classic cachexia found in neoplastic diseases or in severe cardiac conditions. It is due to inadequate dietary consumption and is associated with weight loss. In RA, the muscle loss is somewhat compensated by an increase in body fat, so the body mass index (BMI) remains unaltered or even higher than before and it is called obese cachexia.It is thought to affect two-thirds of these patients 6 and has been linked to high inflammatory activity. 7 Increased production of proinflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)α, and the presence of high levels of inflammatory biomarkers such as C-reactive...

Investigation of Body Compositions and Dietary Habits of Patients with Rheumatoid Arthritis: A Case Control Study

“…In the study of Doubek et al, 32.4% of women with RA were at risk of malnutrition and 1.4% of women were malnourished. In addition, according to BMI, 76% of the participants were overweight or obese, an increase in body fat percentage was found in 98.7% and a decrease in percentage of fat-free mass was found in 95.7% (46). Hejazi et al found that intake of energy and certain micronutrients in women with RA was significantly lower than the recommended values (47).…”

Risk of uveitis in autoimmune diseases patients treated with hydroxychloroquine: A population‐based retrospective cohort study

“…29,30,31 This can lead to a reduction in the inflammatory response and tissue damage in autoimmune diseases. 32,33 Moreover, by inhibiting TLR signaling, suppressing pro-inflammatory cytokine production, and affecting autophagy, HCQ can modulate the immune response and reduce tissue damage in autoimmune diseases. 12 Existing literature indicates that HCQ exhibits promise as a therapeutic candidate for uveitis, mainly highlighted through animal experiments.…”

“…Furthermore, HCQ has also been found to have anti‐inflammatory effects by suppressing the production of pro‐inflammatory cytokines, such as tumor necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6), and interleukin‐1β (IL‐1β) 29,30,31 . This can lead to a reduction in the inflammatory response and tissue damage in autoimmune diseases 32,33 . Moreover, by inhibiting TLR signaling, suppressing pro‐inflammatory cytokine production, and affecting autophagy, HCQ can modulate the immune response and reduce tissue damage in autoimmune diseases 12 .…”