Synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture in Chinese patients with rheumatoid arthritis

Chen, Yang-Fan; Zong, He-Xiang; Xu, Shengqian; Chu, Yi-ran; JX, Wang; Li, Wan-Jun; Chen, Keming

doi:10.1007/s10067-021-05703-w

Cited by 7 publications

(17 citation statements)

References 40 publications

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“…There were patients who shared the same diagnosis but had different histories of GC exposure, which can probably be attributable to differences in disease activity. High disease activity can reflect persistent inflammatory process, which can also play a role in the development of low TBS 28,29 . Further studies focusing on a single disease entity with long‐term and low‐dose GC exposure are needed to confirm our study results and reduce biases to other factors such as disease activity.…”

Section: Discussionmentioning

confidence: 78%

Discriminative ability of trabecular bone score over bone mineral density for vertebral and fragility fracture in patients treated with long‐term and low‐dose glucocorticoid

Lee

Kim

2021

Int J of Rheum Dis

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Aim To evaluate the ability of the trabecular bone score (TBS) to discriminate vertebral fracture (VF) and fragility fracture (FF) in patients with chronic inflammatory rheumatic diseases on long‐term and low‐dose glucocorticoid (GC) treatment and those without exposure to GC. Methods This study assessed TBS and bone mineral density (BMD) in chronic GC users, defined as ≥2.5 mg/d of prednisone for >3 months (n = 89, mean age: 62.5 ± 11 years), and in controls (n = 59, mean age: 60.3 ± 9.6 years). Osteoporosis risk factors, radiographs of the thoracolumbar spine, non‐VF history, osteoporosis drugs, and current/cumulative GC doses were collected. Patients were classified as high (TBS <1.23), intermediate (1.23‐1.31), or low risk (>1.31), according to the fracture risk based on a recent meta‐analysis. Results The mean current dose and duration of GC treatment were 3.9 ± 1.9 mg/d and 3.9 ± 4.2 years, respectively. The prevalence of VF was significantly higher in chronic GC users than in controls (20.2% vs 5.1%, P = .010), although the prevalence of non‐VF was similar (11.2% vs 5.1%). The GC group had significantly lower L1‐L4 TBS and femur total BMD than did the controls (all with P < .01) without significantly different lumbar BMD. TBS (<1.31) showed a higher sensitivity for patients with VF and FF (83.3% and 81.8%, respectively) than with densitometric osteoporosis in the GC group (61.1% and 59.1%, respectively). Using the receiver operating characteristic curve, TBS <1.31 showed better diagnostic accuracy than TBS <1.23 and BMD in chronic GC users. Conclusion TBS is more sensitive than BMD in detecting VF and FF in chronic GC users, even at a lower dose.

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Section: Discussionmentioning

confidence: 78%

Discriminative ability of trabecular bone score over bone mineral density for vertebral and fragility fracture in patients treated with long‐term and low‐dose glucocorticoid

Lee

Kim

2021

Int J of Rheum Dis

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“…After contacting the authors, we learned that 4 studies included some overlap in their respective patient samples, so these studies were included only in descriptive analysis but excluded from pooled analysis. [20][21][22][23]…”

Section: Resultsmentioning

confidence: 99%

“…The duration of studies ranged from 7 to 58 months, with a median duration of 26.5 months. The country of origin of the greatest number of studies was China (6 studies), 7,[20][21][22][23]28 followed by Japan (5 studies), 24,25,[29][30][31] and Germany, 26 New Zealand, 32 South Korea, 33 Spain, 34 and Turkey 27 each with 1 study. Eight studies included both RA patients and healthy control subjects, and 8 studies [24][25][26][28][29][30][31]33 included RA patients only (see Supplementary Table 2, http://links.lww.com/RHU/A568).…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Eight studies included both RA patients and healthy control subjects, and 8 studies [24][25][26][28][29][30][31]33 included RA patients only (see Supplementary Table 2, http://links.lww.com/RHU/A568). Eight studies were rated as having low risk of bias, [20][21][22]25,29,[33][34][35] and 8 studies with medium risk of bias. 23,24,[26][27][28][30][31][32] In addition, there may be a high risk of publication bias due to the limited number of studies published in this area (Fig.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Risk Factors and Clinical Outcomes Associated With Sarcopenia in Rheumatoid Arthritis

Tam

Wong-Pack

Liu³

et al. 2023

J Clin Rheumatol

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Sarcopenia is underrecognized in patients with rheumatoid arthritis (RA). Risk factors of sarcopenia and its impact on outcomes in RA patients are relatively unknown. We conducted a systematic review to identify factors and outcomes associated with sarcopenia in RA. We conducted this review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. We searched PubMed, Embase, CINAHL, and Web of Science databases by combining the following search concepts: (1) RA and (2) sarcopenia. Articles were included if they included RA patients, assessed for sarcopenia using a consensus working group definition, and assessed for clinical outcomes. Meta-analysis was performed using studies that shared the same sarcopenia definition and consistency in reporting patient or disease variables. Our search identified 3602 articles. After removal of duplicates, title and abstract screen, and full-text review, 16 articles were included for final analysis. All studies had observational study designs. The pooled prevalence of sarcopenia ranged from 24% to 30%, depending on the criteria for sarcopenia used. Factors associated with sarcopenia included higher 28-joint Disease Activity Scale scores (+0.39; 95% confidence interval, +0.02 to +0.77) and baseline methotrexate use (odds ratio, 0.70; 95% confidence interval, 0.51-0.97). Baseline glucocorticoid use had a positive correlation with sarcopenia in multiple studies. Several studies found lower bone mineral density and higher incidence of falls and fractures in patients with sarcopenia. Sarcopenia is prevalent in RA, and it may be associated with higher RA disease activity, lower bone mineral density, and increased falls and fractures. Therefore, early screening of sarcopenia in RA patients is important to incorporate into clinical rheumatology practice.

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“…Urrunaga-Pastor et al showed that the factors associated to the presence of poor balance ability were: alcohol consumption, having suffered at least one fall in the last year, exhaustion and at having at least one comorbidity 32 . In previous study, Chen et al studied 238 RA patients and found that RA patients with poor balance often had higher disease activity, severer structural damage, worse joint function and a higher incidence of VOPF compared with RA patients with good balance 33 . We got similar conclusions.…”

Section: Discussionmentioning

confidence: 99%

Effect of sarcopenia and poor balance on vertebral spinal osteoporotic fracture in female rheumatoid arthritis

Zhang

Zong

et al. 2022

Sci Rep

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This study investigated the effect of poor balance and sarcopenia on vertebral spinal osteoporotic fracture (VOPF) in female rheumatoid arthritic (RA) patients. A total of 195 female RA and 126 normal subjects were enrolled, and the correlations between sarcopenia, poor balance and VOPF were analyzed. Furthermore, we explored the relationships between sarcopenia or poor balance with disease related indexes of female RA. Binary logistic regression analyses were performed to identify potential risk factors for VOPF in female RA. We found that female RA had an increased risk of sarcopenia, poor balance (Berg balance scale, BBS ≤ 40) and VOPF than controls (P < 0.0001). Female RA with VOPF were more likely to have poor balance and sarcopenia than those without VOPF (P < 0.0001–0.05). Meanwhile, female RA with sarcopenia and poor balance often had higher disease activity, more serious joint damage and worse joint function (P < 0.05) compared with those without sarcopenia and poor balance. Binary logistic regression analysis (LR backwald) revealed that age (OR = 1.112, 95% CI 1.065–1.160, P < 0.0001), OP (OR = 10.137, 95% CI 4.224–24.330, P < 0.0001) and GCs usage (OR = 3.532, 95% CI 1.427–8.741, P = 0.006) were risk factors, while SMI (OR = 0.386, 95% CI 0.243–0.614, P < 0.0001) and BBS (OR = 0.952, 95% CI 0.929–0.976, P < 0.0001) were protective factors for VOPF in female RA. Hence, sarcopenia and poor balance are associated with a higher risk for VOPF and are closely related to disease activity and joint structure damage of female RA.

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Synergistic effect of sarcopenia and poor balance on osteoporotic vertebral fracture in Chinese patients with rheumatoid arthritis

Cited by 7 publications

References 40 publications

Discriminative ability of trabecular bone score over bone mineral density for vertebral and fragility fracture in patients treated with long‐term and low‐dose glucocorticoid

Discriminative ability of trabecular bone score over bone mineral density for vertebral and fragility fracture in patients treated with long‐term and low‐dose glucocorticoid

Risk Factors and Clinical Outcomes Associated With Sarcopenia in Rheumatoid Arthritis

Effect of sarcopenia and poor balance on vertebral spinal osteoporotic fracture in female rheumatoid arthritis

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