Sarcopenia and Nutrition in Elderly Rheumatoid Arthritis Patients: A Cross-Sectional Study to Determine Prevalence and Risk Factors

Abstract

Objective: To describe the prevalence of sarcopenia in rheumatoid arthritis (RA) patients aged ≥65 years and identify the risk factors associated with sarcopenia. Methods: This is a multicenter, controlled, cross-sectional study of 76 RA patients and 76 age- and sex-matched healthy controls. Sarcopenia was defined according to the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Whole-body dual-energy X-ray absorptiometry (DXA) was performed. Binary regression was used to assess the relationship between sarcopenia and sex, age, duration of RA, Mini Nutritional Assessment (MNA) score, and Short Physical Performance Battery (SPPB) score in patients with RA. Results: Nearly 80% of participants were female, and the average age was >70 years. Patients with RA had lower muscle mass and greater adiposity (fat-to-muscle ratio mean [SD] 0.9 [0.2] vs. 0.8 [0.2]; p = 0.017) than controls, mainly in the central area (android/gynoid ratio, median [p25–p75]: 1.0 [0.9–1.2] vs. 0.9 [0.8–1.1]; p < 0.001). Twelve patients (15.8%) and three controls (3.9%) had confirmed sarcopenia (p = 0.014). Sarcopenic obesity was observed in 8/76 patients with RA (10.5%) and in 1/76 controls (1.3%) (p = 0.016). The factors associated with sarcopenia were male sex (OR [95% CI]: 9.3 [1.1–80.4]; p = 0.042), disease duration (OR [95% CI]: 1.1 [1.0–1.2]; p = 0.012), and nutritional status according to the MNA (OR [95% CI]: 0.7 [0.5–0.9]; p = 0.042). Conclusions: Our results suggest that patients with RA aged ≥65 years may be at increased risk for sarcopenia, adiposity, and malnutrition (especially male patients with long-standing disease) and have poor nutritional status.

Severity and impact of digestive impairment perceived by patients with systemic sclerosis: a cross-sectional study

“…It yields a total score ranging from 0 (worst nutritional status) to 14 (best nutritional status). According to the score, nutrition is classified as normal (>11 points), risk of malnutrition (8–11 points) and malnutrition (0–7 points) 25–27…”

Prevalence of Malnutrition and Associated Factors in Older Patients with Rheumatoid Arthritis: A Cross-Sectional Study

“…The SPPB score ranges from 0 to 12 points, where a higher score is indicative of better physical function. According to the EWGSOP2 guidelines [ 26 ], a score under 10 on the SPPB is indicative of impaired physical performance [ 8 ].…”

“…Similarly, obesity has been associated with inflammation, for the most part via the increased production of proinflammatory lipokines and cytokines in adipose tissue [ 7 ]. In any case, both sarcopenic obesity, which is characterized by reduced lean mass with adiposity, and malnutrition have been associated with increased inflammatory disease activity and poorer outcomes in RA [ 8 ].…”

Osteosarcopenia in women with rheumatoid arthritis: association with nutritional status and physical condition

“…В то же время нам удалось установить связь этого фенотипа состава тела с некоторыми параметрами питания, функционального статуса скелетных мышц и физической активности. В ряде исследований также была отмечена ассоциация между ОСП и нутритивным статусом, оцененным по опроснику MNA-SF, у пожилых людей как без ревматических заболеваний, так и с РА [12,13]. Кроме того, L. Cano-Garcia и соавт.…”

“…Кроме того, L. Cano-Garcia и соавт. [12] выявили связь ОСП с длительностью РА, но не с признаками его активности. Y.R.…”