Sarcopenia and rheumatoid arthritis
Background. Nowadays in the field of syndromes and diseases associated with age, scientists focus especial attention on the problem of sarcopenia, which combines an increased risk of falls, deterioration of life quality, impaired functional activity, reduced life expectancy and increased mortality of patients. In 2016, sarcopenia has been included in the International Classification of Diseases. There are the primary and secondary forms of sarcopenia. This article presents the reference data and results of our own studies on sarcopenia in the rheumatoid arthritis patients. The aim of this study was to evaluate the bone mineral density, lean mass and frequency of prescarcopenia in patients with rheumatoid arthritis. Materials and methods. 461 women aged 40–87 years (age 57.17 ± 0.71 years) were examined, among them 71 patients with rheumatoid arthritis and 390 controls. We conducted the clinical and laboratory examination (erythrocyte sedimentation rate and Creactive protein level in serum). Pain intensity was evaluated by the visual analogue scale, the quality of life – by the HAQ questionnaire. Lean mass, bone mineral density were measured by the Xray absorptiometry (Prodigy, GEHC Lunar, Madison, WI, USA). Presarcopenia (first stage of sarcopenia) was determined when an appendicular lean mass index was less than 5.72 kg/m2 (V.V. Povoroznyuk, N.I. Dzerovich, 2016). Statistical analysis was conducted using the "Statistica 6.0" software. Results. Patients with rheumatoid arthritis had a significantly lower femoral neck mineral density (p = 0.002), lean mass of the total body (p = 0.01) and appendicular lean mass (p < 0.01). The frequency of presarcopenia in women with rheumatoid arthritis was 49 %, in the control group — 18 %. Conclusions. Patients with rheumatoid arthritis had not only bone tissue, but also skeletal muscle tissue disorders, resulting in a significant deterioration of functional capacity and quality of life. Given the significant medical and social significance of the problem, further studies into the mechanisms of pathogenesis, development of diagnostic methods, prevention and treatment of sarcopenia in patients with rheumatoid arthritis are required.
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