Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis

Jin, Shunqian; Li, Mengtao; Fang, Yongfei; Li, Qin; Liu, Ju; Duan, Xinwang; Liu, Yi; Wu, Rui; Shi, Xiaofei; Wang, Yongfu; Jiang, Zhenyu; Wang, Yanhong; Chen, Yu; Wang, Qian; Tian, Xin; Zhao, Yan; Zeng, Xiaofeng; Co-authors, CREDIT

doi:10.1186/s13075-017-1457-z

Cited by 80 publications

(71 citation statements)

References 43 publications

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“…Interestingly, in both Chinese studies, overall malignancy risk was not higher in RA patients compared to the general population. 34,35 This finding was also true in the Korean study. 33 These data suggest that apart from race, geographic and environmental factors may also play a part in influencing the risk of malignancy in RA patients.…”

Section: Discussionsupporting

confidence: 70%

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Incidence and patterns of malignancies in a multi‐ethnic cohort of rheumatoid arthritis patients

et al. 2019

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Aim This study was undertaken to determine the incidence and patterns of malignancies in rheumatoid arthritis (RA) patients in our cohort. Methods Between 2001 and 2013, we analyzed 1117 patients in the prospective Tan Tock Seng Hospital (TTSH) RA Registry. Patients who developed malignancies after the onset of RA were identified from this registry. Age‐ and sex‐adjusted standardized incidence ratios (SIRs) were calculated to compare observed to expected numbers of malignancies based on data from the Singapore Cancer Registry. Results Out of 19 839 person‐years of follow‐up, 132 incident malignancies were diagnosed during the observation period. There were 114 (86.4%) solid‐organ tumors and 18 (13.6%) hematological malignancies. The SIR (95% confidence interval) for all malignancies combined was 1.28 (0.88‐1.87) for males and 1.21 (1.00‐1.46) for females. Compared to the general population, we found a 4‐ to 5‐fold increase in lymphoma among our RA patients compared to the general population (SIR 5.05 [1.90‐13.46] for males and 3.75 [1.95‐7.20] for females). The SIR of lung malignancy in male RA patients is 2.36 (1.23‐4.53) and SIR of cervical malignancy in female RA patients is 3.72 (2.20‐6.23). Conclusion There is a trend toward an overall increased malignancy risk in our RA patients compared to the general population. Specifically, there is an increased risk of lymphomas in all RA patients, lung malignancy in male patients, and cervical malignancy in female patients, compared to the general population.

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Section: Discussionsupporting

confidence: 70%

“…There are limited studies done in Asian populations other than the two Japanese, 1 Taiwanese, one Korean, and a few Chinese studies. Interestingly, in both Chinese studies, overall malignancy risk was not higher in RA patients compared to the general population . This finding was also true in the Korean study .…”

Section: Discussionsupporting

confidence: 59%

Incidence and patterns of malignancies in a multi‐ethnic cohort of rheumatoid arthritis patients

et al. 2019

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“…Risk factors and outcome measurement at the same timeframe made it scientifically inappropriate to determine the causality between myopenia and RA joint destruction. The baseline characteristics of recruited RA patients in our study were similar to the Chinese Registry of Rheumatoid Arthritis including 13 210 RA patients (80.6% female, mean age 52.9 years, and median disease duration 4.0 years) from 173 centres in 31 provinces all over China. Secondly, the controls in our study comprising mainly white‐collar volunteer employees were younger than RA group featuring with lower prevalence of obesity (5.2% vs. 13.1%) and slightly higher prevalence of underweight (7.8% vs. 3.8%) than that of Chinese adults in the registry .…”

Section: Discussionmentioning

confidence: 84%

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Lin

Liang

et al. 2019

J cachexia sarcopenia muscle

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Background The link between body mass index (BMI) and disease characteristics in rheumatoid arthritis (RA) remains controversial. Body composition (BC) has been more frequently recommended to be used instead of BMI for more accurate assessment. Our study aimed to investigate the characteristics of BC in RA patients and their associations with disease characteristics. Methods Body composition was assessed in consecutive Chinese RA patients and control subjects by bioelectric impedance analysis. Overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. Myopenia was defined by appendicular skeletal muscle mass index (ASMI) ≤7.0 kg/m 2 in men and ≤5.7 kg/m 2 in women. BMI and clinical data including disease activity, function, and radiographic assessment were collected. Active disease was defined by disease activity score in 28 joints with four variables including C‐reactive protein (DAS28‐CRP) ≥2.6. Functional limitation was defined as Stanford health assessment questionnaire disability index (HAQ‐DI) >1. Radiographic joint damage (RJD) was defined as the Sharp/van der Heijde modified sharp score (mTSS) >10. Results There were 457 RA patients (mean age 49.5 ± 13.1 years old with 82.7% women) and 1860 control subjects (mean age 34.3 ± 9.9 years old with 51.2% women) recruited. Comparisons of BMI and BC between RA patients and control subjects in age and gender stratification showed that lower BMI with 17.7% underweight and lower ASMI with 45.1% myopenia are the main characteristics in RA patients. Compared with those without myopenia, RA patients with myopenia had significantly higher DAS28‐CRP (median 3.5 vs. 3.0), higher HAQ‐DI (median 0.38 vs. 0.13) with higher rate of functional limitation (24.8% vs. 7.6%), and higher mTSS (median 22.3 vs. 9.0) with more RJD (71.8% vs. 45.8%) (all P < 0.001). Multivariate logistic regression analysis showed myopenia were positively associated with functional limitation (OR = 2.546, 95% CI: 1.043–6.217) and RJD (OR = 2.660, 95% CI: 1.443–4.904). All RA patients were divided into four BC subgroups according to overfat and myopenia. Those with both overfat and myopenia had the worst disease characteristics. After adjustment for confounding factors, significant additive interactions were observed between overfat and myopenia in active disease (AP = 0.528, 95% CI: 0.086–0.971), functional limitation (AP = 0.647, 95% CI: 0.356–0.937), and RJD (AP = 0.514, 95% CI: 0.139–0.890). Conclusions Myopenia is very common in RA patients that is associated with functional limitation and joint damage in RA. Further research on the underlying mechanism and the effect of skeletal muscle mass improvement in RA management are worth exploring in the future.

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“…However, most of the studies were conducted in western and middle eastern countries. There are few studies from Asian populations and the outcomes differ [13,14]. Thus, the present study was conducted to determine left ventricular structure and function and arterial wall stiffness.…”

Section: Introductionmentioning

confidence: 98%

Disease activity is associated with LV dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

Hanvivadhanakul

Buakhamsri

2019

Adv Rheumatol

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Objectives: The cross-sectional study aimed to assess left ventricular systolic function using global longitudinal strain (GLS) by speckle-tracking echocardiography (STE) and arterial stiffness using cardio-ankle vascular index (CAVI) in Thai adults with rheumatoid arthritis (RA) and no clinical evidence of cardiovascular disease (CVD). Methods: Confirmed RA patients were selected from a list of outpatient attendees if they were 18 years (y) without clinical, ECG and echocardiographic evidence of CVD, diabetes mellitus, chronic kidney disease, and excess alcoholic intake. Controls were matched with age and sex to a list of healthy individuals with normal echocardiograms. All underwent STE and CAVI. Results: 60 RA patients (females = 55) were analysed. Mean standard deviation of patient and control ages were 50 ± 10.2 and 51 ± 9.9 y, respectively, and mean duration of RA was 9.0 ± 6.8 y. Mean DAS28-CRP and DAS28-ESR were 2.9 ± 0.9 and 3.4 ± 0.9, respectively. There was no between-group differences in left ventricular ejection fraction (LVEF), LV sizes, LVMI, LV diastolic function and CAVI were within normal limits but all GLSs values was significantly lower in patients vs. controls: 17.6 ± 3.4 vs 20.4 ± 2.2 (p = 0.03). Multivariate regression analysis demonstrated significant correlations between GLSs and RA duration (p = 0.02), and GLSs and DAS28-CRP (p = 0.041). Conclusions: Patients with RA and no clinical CV disease have reduced LV systolic function as shown by lower GLSs. It is common and associated with disease activity and RA disease duration. 2D speckle-tracking GLSs is robust in detecting this subclinical LV systolic dysfunction.

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Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis

Cited by 80 publications

References 43 publications

Incidence and patterns of malignancies in a multi‐ethnic cohort of rheumatoid arthritis patients

Incidence and patterns of malignancies in a multi‐ethnic cohort of rheumatoid arthritis patients

Myopenia is associated with joint damage in rheumatoid arthritis: a cross‐sectional study

Disease activity is associated with LV dysfunction in rheumatoid arthritis patients without clinical cardiovascular disease

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