Deficits in muscle mass, muscle density, and modified associations with fat in rheumatoid arthritis.
Deficits in muscle mass, muscle density, and modified associations with fat in rheumatoid arthritis.
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DOI：
10.1002/acr.22328
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发表时间：
2014-11
影响因子：
4.7
通讯作者：
Leonard MB
中科院分区：
文献类型：
--
作者：
Baker JF;Von Feldt J;Mostoufi-Moab S;Noaiseh G;Taratuta E;Kim W;Leonard MB
量化与健康对照相比，类风湿性关节炎（RA）患者与脂肪量无关的肌肉结果。定量计算机断层扫描测量了小腿肌肉和脂肪横截面积（CSA）和肌肉密度（肌内脂肪组织指数），并使用等长测力法测量了50名年龄在18-70岁之间的RA参与者和500名健康对照者的脚踝肌肉力量。多变量线性回归模型在调整肥胖组差异和评估改变的肌肉脂肪关联后评估RA的肌肉缺陷。还评估了类风湿性关节炎疾病特征与脂肪调节肌肉结果之间的关系。与对照组相比，RA受试者的体重指数（BMI）和脂肪面积显著增加，肌肉面积、肌肉密度和肌肉力量均显著降低（P < 0.001）。通过调整较小的肌肉面积，消除了力量不足。与对照组相比，脂肪面积和体重指数较低的参与者肌肉缺陷的程度明显更大（相互作用P < 0.03）。在肥胖程度较低的人群中，与肥胖程度相似的对照组相比，RA受试者表现出更显著的缺陷。相反，在肥胖发生率最高的人群中，类风湿关节炎与肌肉缺陷无关。在RA中，较高的Sharp/van der Heijde评分与较低的肌肉CSA和肌肉密度相关。更大的疾病活动和残疾与低肌肉密度有关。与对照组相比，RA患者存在肌肉面积和肌肉密度的缺陷，并且在低脂肪量的受试者中最为明显。更大的关节破坏与更大的肌肉缺陷有关。
To quantify muscle outcomes, independent of fat mass, in rheumatoid arthritis (RA) patients compared to healthy controls. Quantitative computed tomography scans measured calf muscle and fat cross-sectional area (CSA) and muscle density (an index of intramuscular adipose tissue), and isometric dynamometry was used to measure ankle muscle strength in 50 participants with RA ages 18–70 years and 500 healthy controls. Multivariable linear regression models assessed muscle deficits in RA after adjusting for group differences in adiposity and assessing for an altered muscle–fat association. Associations between RA disease characteristics and fat-adjusted muscle outcomes were also assessed. Compared to controls, RA subjects had significantly greater body mass index (BMI) and fat area, and lower muscle area, muscle density, and muscle strength (P < 0.001 for all). Strength deficits were eliminated with adjustment for the smaller muscle area. The magnitude of muscle deficits, relative to controls, was significantly greater (P < 0.03 for interaction) in participants with lower fat area and BMI. Among those in the lower tertiles of adiposity, RA subjects demonstrated more significant deficits compared to controls with similar adiposity. In contrast, among those in the highest tertile for adiposity, RA was not associated with muscle deficits. Among RA, greater Sharp/van der Heijde scores were associated with lower muscle CSA and muscle density. Greater disease activity and disability were associated with low muscle density. Deficits in muscle area and muscle density are present in RA patients compared to controls and are most pronounced in subjects with low fat mass. Greater joint destruction is associated with greater muscle deficits.