Myokine myostatin is a novel predictor of one-year radiographic progression in patients with rheumatoid arthritis: A prospective cohort study.
Myokine myostatin is a novel predictor of one-year radiographic progression in patients with rheumatoid arthritis: A prospective cohort study.
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DOI：
10.3389/fimmu.2022.1005161
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
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类风湿性关节炎（RA）和骨骼肌减少之间的关系已被研究，我们首次报道肌减少独立预测一年的放射学进展的RA。肌因子myostatin可负性调节骨骼肌质量，促进破骨细胞分化。然而，关于它们在RA患者中的关系尚未见报道。我们首先探讨血清肌生长抑制素与疾病特征的关系，以及在一年的随访中关节破坏加重。从真实世界前瞻性队列中招募连续性RA患者，并完成至少一年的随访。采用酶联免疫吸附试验测定基线血清肌生长抑制素水平。收集RA患者的临床数据以及RA患者和健康对照组的肌肉指数。作为主要结局的1年放射学进展定义为总Sharp/货车der Heijde改良评分变化≥0.5个单位。入选RA患者344例（年龄47.9 ± 12.5岁，84.0%为女性）和健康对照组118例（年龄42.8 ± 11.3岁，74.6%为女性）。与健康对照组相比，RA患者基线时血清肌生长抑制素水平较高（3.241 ± 1.679 ng/ml vs.1.717 ± 0.872 ng/ml，P<0.001），但关节外骨骼肌质量指数较低（ASMI，6.0 ± 0.9 kg/m2 vs.6.5 ± 1.0 kg/m2，P<0.001）。在RA患者中，高肌生成抑制素组的放射学进展率高于低肌生成抑制素组（45.3%比18.6%，P<0.001）。根据血清肌生成抑制素水平和肌减少程度将RA患者分为4个亚组。与其他三个亚组相比，高肌抑制素重叠肌减少的RA患者在1年随访期间的放射学进展率最高（67.2%vs.10.3%~ 31.4%，P<0.001），缓解率最低，躯体功能障碍率最高。调整混杂因素后，高血清肌生长抑制素（AOR=3.451，95%CI：2.016-5.905）和肌减少症（AOR=2.387，95%CI：1.416-4.022）是1年放射学进展的危险因素，尤其是高肌抑制素重叠肌减少的患者（AOR=10.425，95%CI：3.959-27.450）为4个亚组中的最高风险个体。在1年放射学进展中，高肌生长抑制素和肌减少之间观察到显著的协同交互作用（AP= 66.3%，95%CI：43.2%-89.3%）。肌生长抑制素是RA患者关节破坏加重的一个新的预测因子，与肌减少有协同作用，具有预测价值。
Associations between rheumatoid arthritis (RA) and reduced skeletal muscle have been studied, and we firstly reported myopenia independently predict one-year radiographic progression in RA. Myokine myostatin can negatively regulate skeletal muscle mass and promote osteoclast differentiation. However, there is no report about their relationships in RA patients. We firstly explored the relationship of serum myostatin and disease characteristics, as well as aggravated joint destruction during one-year follow-up. Consecutive RA patients were recruited from a real-world prospective cohort and completed at least one-year follow-up. Baseline serum level of myostatin was measured by enzyme-linked immunosorbent assay. Clinical data in RA patients as well as muscle index in both RA patients and healthy controls were collected. One-year radiographic progression as primary outcome was defined by a change in the total Sharp/van der Heijde modified score ≥0.5 units. Totally 344 RA patients (age 47.9 ± 12.5 years, 84.0% female) and 118 healthy control subjects (age 42.8 ± 11.3 years, 74.6% female) were recruited. Compared with healthy controls, RA patients showed a higher level of serum myostatin at baseline (3.241 ± 1.679 ng/ml vs. 1.717 ± 0.872 ng/ml, P<0.001), although lower appendicular skeletal muscle mass index (ASMI, 6.0 ± 0.9 kg/m2 vs. 6.5 ± 1.0 kg/m2, P<0.001). In RA patients, those with high myostatin level showed a higher rate of radiographic progression than low myostatin group (45.3% vs. 18.6%, P<0.001). Furtherly, RA patients were stratified into four subgroups according to serum myostatin and myopenia. Compared with other three subgroups, RA patients with high myostatin overlapping myopenia had the highest rate of radiographic progression (67.2% vs. 10.3%-31.4%, P<0.001), as well as the lowest proportion of remission and the highest rate of physical dysfunction during one-year follow-up. After adjustment for confounding factors, high serum myostatin (AOR=3.451, 95%CI: 2.016-5.905) and myopenia (AOR=2.387, 95%CI: 1.416-4.022) at baseline were risk factors for one-year radiographic progression, especially for those with high myostatin overlapping myopenia (AOR=10.425, 95%CI: 3.959-27.450) as the highest-risk individuals among four subgroups. Significant synergistic interaction effect was observed between high myostatin and myopenia on one-year radiographic progression (AP=66.3%, 95%CI: 43.2%-89.3%). Myostatin is a novel predictor of aggravated joint destruction in RA patients which has synergistic interaction with myopenia for predicting value.
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影响因子：
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