Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function

Santillán-Díaz, Cira; Ramírez-Sánchez, Noemi; Espinosa-Morales, Rolando; Orea-Tejeda, Arturo; Llórente, Luis; Rodríguez-Guevara, Gerardo; Castillo-Martı́nez, Lilia

doi:10.1007/s10067-017-3889-x

Cited by 9 publications

(15 citation statements)

References 38 publications

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“…Rheumatoid cachexia is characterized by loss of muscle with or without weight loss in the presence of stable or increased fat mass. Although there is no consensus criterion for diagnosis of rheumatoid cachexia, it has been reported ranging from 17% to 60% in RA …”

Section: Introductionmentioning

confidence: 99%

“…Although there is no consensus criterion for diagnosis of rheumatoid cachexia, it has been reported ranging from 17% to 60% in RA. [12][13][14] Instead of BMI, more accurate body composition (BC), including fat mass, muscle mass, and other tissues, has been frequently recommended to assess metabolic status. There are four main techniques commonly used to evaluate BC in clinical practice: DXA, computed tomography, magnetic resonance imaging, and bioelectric impedance analysis (BIA).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…This result may reflect another aspect of the lower FFMI, BMI, WC, and body weight found in patients with RC compared to those without RC in this study. Earlier studies linked RC with low subjectively reported physical activity (29) and poor physical function (13,33). In this study, low-intensity physical activity was inversely associated with RC.…”

Section: Rheumatoid Cachexia and Associated Variablesmentioning

confidence: 50%

Rheumatoid cachexia in early rheumatoid arthritis: prevalence and associated variables

Ångström

Hörnberg

Sundström

et al. 2021

Scandinavian Journal of Rheumatology

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Objective: Rheumatoid cachexia (RC) is prevalent among patients with established rheumatoid arthritis (RA). Although changes in muscle mass and fat mass have been reported in early RA, these findings have not been classified according to existing RC definitions. This study aimed to describe the prevalence of RC and associated variables in patients with early RA. Method: This cross-sectional study included 87 patients. Body composition was evaluated with dual-energy X-ray absorptiometry after a median disease duration of 15 months. RC was defined as a fat-free mass index < 10th percentile and fat mass index > 25th percentile. We also assessed the erythrocyte sedimentation rate (ESR), C-reactive protein, Disease Activity Score in 28 joints, aerobic capacity, physical activity, traditional cardiovascular disease risk factors, functional disability, and sociodemographic data. Associations between RC and the independent variables were determined with logistic regression analyses. Results: The prevalence of RC was 24%. RC was significantly associated [odds ratio (95% confidence interval)] with aerobic capacity [0.28 (0.09-0.89), p = 0.030], low-intensity physical activity [0.77 (0.60-0.99), p = 0.048], body mass index [0.78 (0.70-0.92), p = 0.002], waist circumference [0.96 (0.92-0.99), p = 0.023], body weight [0.94 (0.90-0.98), p = 0.004], and ESR at the time of diagnosis [1.02 (1.00-1.05), p = 0.033]. All of these associations remained significant after adjusting for age and gender. Conclusion: RC was highly prevalent in early RA. Patient outcome may be improved by detecting this condition early and applying treatments for improving inflammation, aerobic capacity, physical activity, and body composition.

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“…32 Previous studies showed that Swedish RA patients with rheumatoid cachexia were associated with serum CRP levels, DAS28, HAQ score, cholesterol levels and high frequency of hypertension. 27,28 Another Mexico study showed that rheumatoid cachexia was related to disability (OR of 4.69) but negatively related to methotrexate treatment (OR of 0.19), 33 while a review reported no association between rheumatoid cachexia and rheumatoid disease severity, such as disease duration, swollen joint counts, mean ESR, or prednisolone treatment. 13 The clinical features in normal BMI RA patients with myopenia overlapping overfat have not been reported.…”

Section: Discussionmentioning

confidence: 99%

Neglected extra-articular manifestations in rheumatoid arthritis patients with normal body mass index: reduced skeletal muscle overlapping overfat

Lin

Chen

et al. 2020

Therapeutic Advances in Chronic Disease

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Background: Chronic inflammation in rheumatoid arthritis (RA) can induce reduced muscle mass (myopenia) and ectopic fat deposition probably showing normal body mass index (BMI). We aimed to investigate their body composition (BC) characteristics and clinical significance. Methods: BMI and BC were collected in consecutive RA patients and control subjects. Myopenia was defined by appendicular skeletal muscle mass index (ASMI) ⩽7.0 kg/m2 in men and ⩽5.7 kg/m2 in women. Overfat was defined by body fat percentage (BF%) as ⩾25% for men and ⩾35% for women. Results: There were 620 RA patients (57.6% with normal BMI) and 2537 control subjects (62.5% with normal BMI) recruited. After 1:1 age and sex matching with control subjects, RA patients with normal BMI ( n = 240) showed significantly higher prevalence of myopenia (43.3% versus 22.1%) and overfat (19.2% versus 7.1%) as well as myopenia overlapping overfat (17.1% versus 3.3%). In all RA patients with normal BMI ( n = 357), there were 18.2% patients with myopenia overlapping overfat who had the worst radiographic scores and highest rates of previous glucocorticoid treatment and hypertension. Compared with those without, normal BMI RA patients with previous glucocorticoid treatment (24.4% versus 10.3%) or hypertension (27.8% versus 13.6%) had a higher rate of myopenia overlapping overfat. Previous glucocorticoid treatment [odds ratio (OR) = 2.844, 95% confidence interval (CI) 1.441–5.614] and hypertension (OR = 2.452, 95% CI 1.283–4.685) were potential associated factors of myopenia overlapping overfat in RA patients with normal BMI. Conclusion: Myopenia overlapping overfat is an important extra-articular manifestation which should not be ignored in RA patients with normal BMI, especially with glucocorticoid treatment and hypertension.

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Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function

Cited by 9 publications

References 38 publications

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

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

Rheumatoid cachexia in early rheumatoid arthritis: prevalence and associated variables

Neglected extra-articular manifestations in rheumatoid arthritis patients with normal body mass index: reduced skeletal muscle overlapping overfat

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