Reduced skeletal muscle independently predicts 1-year aggravated joint destruction in patients with rheumatoid arthritis

Abstract

Background: Numerous cross-sectional studies have reported the associations between rheumatoid arthritis (RA) and reduced skeletal muscle. We firstly explored the dynamic change of skeletal muscle and its effect on RA clinical outcomes in a real-world prospective cohort. Methods: Consecutive RA patients were treated according to the treat-to-target strategy and completed at least 1-year follow up. Clinical data and muscle index (assessed by bioelectric impedance analysis) were collected at baseline and visits at 3, 6, 9 and 12 months. Myopenia was defined by appendicular skeletal muscle mass index ⩽7.0 kg/m2 in men and ⩽5.7 kg/m2 in women. A 1-year radiographic progression as primary outcome was defined by a change in the total Sharp/van der Heijde modified score ⩾0.5 units. Results: Among 348 recruited patients, 315 RA patients (mean age 47.9 years, 84.4% female) completed 1-year follow up. There were 143 (45.4%) RA patients showing myopenia at baseline. Compared with those without baseline myopenia, RA patients with baseline myopenia had higher rate of 1-year radiographic progression (43.4% versus 21.5%, all p < 0.05). Baseline myopenia was an independent risk factor for 1-year radiographic progression with adjusted odds ratio (AOR) of 2.5-fold, especially among RA patients in remission at baseline both defined by Disease Activity Score in 28 joints (DAS28) including C-reactive protein (DAS28-CRP) or erythrocyte sedimentation rate (DAS28-ESR) with AOR of 18.5~42.9-fold. Further analysis of six subtypes of dynamic skeletal muscle change showed that newly acquired myopenia at endpoint was associated with radiographic progression (AOR of 5.4-fold). Conclusions: Reduced skeletal muscle is an independent predicting factor for 1-year aggravated joint destruction, especially in remission RA. The importance of dynamic monitoring of skeletal muscle and muscle improvement therapy are worth exploration.

Non-causal Effect of Circulating Vitamin D Levels on the Risk of Rheumatoid Arthritis: A Two-sample Mendelian Randomization Study

“…2 In ammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China. 3 Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University Medical College, Suzhou, China. 4 Department of Rheumatology and Immunology, the First A liated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, China.…”

“…RA appears mostly in women and may occur at any age, with a peak incidence between 50 and 60 years old [1]. In general, progressive disability and shortened life expectancy are almost universal in RA patients [2], furthermore, physical pain also seriously affects the quality of life [3]. The exact pathogenesis of RA is not yet known [4], but it is believed that environmental, genetic, and infectious factors may interact in susceptible individuals and the heritability of RA is approximately 65% [5].…”

Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials

“…4 Previous observational studies have reported that almost 36%-55% of patients with rheumatoid arthritis have myopenia (i.e. low skeletal muscle mass), [5][6][7] and approximately 29%-38% have sarcopenia. 7,8 In addition, an incidence of myopenia has been reported as high as 9.3% over one year follow up for patients with rheumatoid arthritis who initially were not classified as myopenia.…”

“…7,8 In addition, an incidence of myopenia has been reported as high as 9.3% over one year follow up for patients with rheumatoid arthritis who initially were not classified as myopenia. 6 Older adult patients with sarcopenia tend to have greater physical difficulty relative to their peers without sarcopenia; 2,9 this phenomenon is also present in patients with rheumatoid arthritis. 5,10,11 In recent research on the relationship between skeletal muscle mass and disability in rheumatoid arthritis, low muscle mass was significantly associated with a severe disability score.…”

C-Reactive Protein Knock Out Attenuate Temporomandibular Joint Inflammation in Rats

“…Although it has long been regarded as a marker of acute in ammation, recent studies have shown that CRP also plays an important regulatory role in a variety of chronic in ammatory related diseases [19,20]. It has long been recognized that elevated serum CRP correlates positively with RA severity and progression, and systemic CRP level is signi cantly increased in OA patients [21,22].…”