Background Musculoskeletal disorders in RA are characterized by lesions of the peripheral joints, the development of local and systemic osteoporosis (OP), as well as a decrease in muscle mass and strength, which are currently being considered within the framework associated with chronic diseases syndrome sarcopenia and cachexia.
Objectives To determine the prevalence and the relationship between sarcopenia and OP in patients with RA.
Methods 156 RA patients were examined, of whom 83 postmenopausal women (mean age-61.7 years) and 73 males (mean age, 59 years). The control group consisted of 35 healthy subjects matched for age and sex. Exclusion criteria were: other rheumatic and endocrine diseases, severe somatic diseases, cancers, etc. The states of bone mineral density (BMD) at the lumbar spine (L1-L4) and femoral bone were assessed by dual-energy X-ray absorptiometry (DXA).
Results Most RA patients (83% women and 63% men) were observed to decrease in BMD of osteopenia/OP level. BMD were negatively correlated with radiographic stage of RA, the DAS 28 and HAQ. IPC also revealed significant correlations with laboratory parameters such as creatinine, total protein, albumin, rheumatoid factor, and 1,25 (OH) D. Investigation of body composition showed a statistically significant reduction ITM RA patients compared to the control group, with no differences between the groups for fat mass. Sarcopenia had 25% of women and 55% men with RA, whereas the control groups, 8.7% and 0%, respectively. The majority of patients of both sexes sarcopenia observed on the background of the normal range of body fat index. Status of TM in patients with RA was statistically significant (p<0,05) associated with femoral BMD and lumbar spine (r=0,3), BMI (r=0,5), force brush compression (r=0,4) RA radiographic stage (r= -0,4), indicators of total protein (r=0,5).
Conclusions Patients with RA, together with OP/osteopenia have a significant reduction in muscle (lean) mass. Sarcopenia in patients with RA was observed in the majority of men (55%) and 25% of women, significantly more than the control groups. Implementation of the DRA with the program “whole body” will allow time to identify not only bone, but also muscle loss in RA patients, which will help to intensify targeted therapy.
Disclosure of Interest None declared