Abnormal body composition phenotypes in Vietnamese women with early rheumatoid arthritis
Abnormal body composition phenotypes in Vietnamese women with early rheumatoid arthritis
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DOI：
10.1093/rheumatology/ker004
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发表时间：
2011-07-01
期刊：
影响因子：
5.5
通讯作者：
Sakamoto, Junichi
中科院分区：
文献类型：
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作者：
Hanh-Hung Dao;Quan-Trung Do;Sakamoto, Junichi
方法.共有105名女性早期RA（疾病持续时间3年）和105名年龄匹配的健康女性进行了体格检查，总的和区域瘦体重（LM）和脂肪质量（FM）与DXA。记录28个关节DAS（DAS-28）和HAQ评分、营养、体力活动和药物治疗的残疾情况。RA患者和对照组的体重和BMI均值相似，但RA患者的全身和躯干FM均值较高：分别为19.1 vs 16.9 kg（P = 0.007）和10.1 vs 8.1 kg（P = 0.01），而四肢LM较低：12.9 vs 14.1 kg（P = 0.02）。RA患者中不健康身体成分表型（少肌症、肥胖症和少肌症性肥胖）的比例高于对照组（P < 0.001）。DAS-28评分与总FM和脂肪分布率呈正相关，HAQ评分与无脂肪LM呈负相关。这些身体成分变化与RF血清阳性、HAQ和DAS-28评分相关。与对照组相比，早期类风湿性关节炎患者的身体成分表型不健康的比例显著较高，总FM和躯干FM较高，而非躯干LM较低。疾病活动和残疾评分与不健康的身体成分有关。这些发现表明，临床医生应该鼓励RA患者加强肌肉和脂肪减少，以减少他们的残疾。
Methods. A total of 105 women with early RA (disease duration 3 years) and 105 age-matched healthy women underwent physical examination, total and regional lean mass (LM) and fat mass (FM) with DXA. The 28-joint DAS (DAS-28) and disability using HAQ score, nutrition, physical activity and medications were recorded.Results. Means of weight and BMI were similar in RA patients and controls, but means of total body and trunk FM in RA patients were higher: 19.1 vs 16.9 kg (P = 0.007) and 10.1 vs 8.1 kg (P = 0.01), respectively, and appendicular LM was lower: 12.9 vs 14.1 kg (P = 0.02). The proportion of unhealthy body composition phenotypes (sarcopenia, overfat and sarcopenic obesity) in RA patients was higher (P < 0.001) than in controls. DAS-28 score was positively correlated with total FM and fat distribution ratio, and HAQ score was inversely correlated with appendicular LM. These body composition changes were associated with RF seropositivity, HAQ and DAS-28 scores.Conclusions. Women with early RA had a significantly higher proportion of unhealthy body composition phenotypes, higher total and truncal FM and lower appendicular LM than controls. Disease activity and disability scores were associated with unhealthy body composition. These findings suggest that clinicians should encourage muscle strengthening and fat loss in RA patients to reduce their disability.