Association of body composition with disease activity and disability in rheumatoid arthritis
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Background/Aims: To explore the associations between body composition and pain, disease activity, and disability in rheumatoid arthritis (RA). Methods: The study enrolled 335 patients with RA and underwent body composition measurement with an InBody analyzer. The associations of body mass index (BMI), body fat mass, and skeletal muscle mass with disease activity score in 28 joints (DAS28), an index derived to measure the subjective component of DAS28 (DAS28-P), a pain visual analogue scale (VAS), and disability measured with the health assessment questionnaire (HAQ) were explored. Obesity was defined as BMI ≥ 25 kg/m2. Results: The median (interquartile range) disease duration was 6 years (3.5 to 9) and the mean DAS28 score was 3.6 ± 1.1. The mean BMI was 23.6 ± 3.6 kg/m2 and 109 patients (32.5%) were obese. Compared with non-obese patients, obese patients had a higher C-reactive protein (1.68 mg/dL vs. < 0.1 mg/dL, p = 0.013), higher pain VAS score (40 vs. 35, p = 0.031), and higher DAS28-erythrocyte sedimentation rate score (3.75 ± 1.18 vs. 3.46 ± 1.11, p = 0.031). In multivariate regression analysis, the DAS28 score in females was positively associated with the current steroid dose, body fat mass, and HAQ score, while the HAQ score in females was associated with older age, DAS28, lower skeletal muscle mass, and higher body fat/skeletal muscle ratio. In the multivariate regression analysis, the DAS28-P score in females was positively associated with body fat/skeletal muscle ratio and HAQ. Conclusions: Body composition, such as the body fat mass and body fat/skeletal muscle ratio, is significantly associated with disease activity and disability in female RA patients.
Abstract
Background/Aims: To explore the associations between body composition and pain, disease activity, and disability in rheumatoid arthritis (RA). Methods: The study enrolled 335 patients with RA and underwent body composition measurement with an InBody analyzer. The associations of body mass index (BMI), body fat mass, and skeletal muscle mass with disease activity score in 28 joints (DAS28), an index derived to measure the subjective component of DAS28 (DAS28-P), a pain visual analogue scale (VAS), and disability measured with the health assessment questionnaire (HAQ) were explored. Obesity was defined as BMI ≥ 25 kg/m2. Results: The median (interquartile range) disease duration was 6 years (3.5 to 9) and the mean DAS28 score was 3.6 ± 1.1. The mean BMI was 23.6 ± 3.6 kg/m2 and 109 patients (32.5%) were obese. Compared with non-obese patients, obese patients had a higher C-reactive protein (1.68 mg/dL vs. < 0.1 mg/dL, p = 0.013), higher pain VAS score (40 vs. 35, p = 0.031), and higher DAS28-erythrocyte sedimentation rate score (3.75 ± 1.18 vs. 3.46 ± 1.11, p = 0.031). In multivariate regression analysis, the DAS28 score in females was positively associated with the current steroid dose, body fat mass, and HAQ score, while the HAQ score in females was associated with older age, DAS28, lower skeletal muscle mass, and higher body fat/skeletal muscle ratio. In the multivariate regression analysis, the DAS28-P score in females was positively associated with body fat/skeletal muscle ratio and HAQ. Conclusions: Body composition, such as the body fat mass and body fat/skeletal muscle ratio, is significantly associated with disease activity and disability in female RA patients.
참고문헌 (23)
- Kerekes G, "Rheumatoid arthritis and metabolic syndrome", Nat Rev Rheumatol, 10, pp.691~696 (2014)
- Roubenoff R, "Rheumatoid cachexia : depletion of lean body mass in rheumatoid arthritis. Possible association with tumor necrosis factor", J Rheumatol, 19, pp.1505~1510 (1992)
- Book C, "Early rheumatoid arthritis and body composition", Rheumatology(Oxford), 48, pp.1128~1132 (2009)
- Kramer HR, "Muscle density in rheumatoid arthritis : associations with disease features and functional outcomes", Arthritis Rheum, 64, pp.2438~2450 (2012)
- Lupoli R, "Impact of body weight on the achievement of minimal disease activity in patients with rheumatic diseases : a systematic review and meta-analysis", Arthritis Res Ther, 18, pp.297~ (2016)
- Liu Y, "Impact of obesity on remission and disease activity in rheumatoid arthritis: a systematic review and meta-analysis", Arthritis Care Res(Hoboken), 69, pp.157~165 (2017)
- Schulman E, "Overweight, obesity, and the likelihood of achieving sustained remission in early rheumatoid arthritis: results from a multicenter prospective cohort study", Arthritis Care Res(Hoboken), 70, pp.1185~1191 (2018)
- Sandberg ME, "Overweight decreases the chance of achieving good response and low disease activity in early rheumatoid arthritis", Ann Rheum Dis, 73, pp.2029~2033 (2014)
- Ajeganova S, "Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: a long-term follow up from disease onset", Arthritis Care Res(Hoboken), 65, pp.78~87 (2013)
- McWilliams DF, "Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study", Arthritis Care Res(Hoboken), 64, pp.1505~1513 (2012)
- Son KM, "Contribution of subjective Disease Activity Score 28(DAS28)components to the response to treatment of rheumatoid arthritis", Clin Rheumatol, 36, pp.1221~1227 (2017)
- Book C, "Changes in body composition after 2 years with rheumatoid arthritis", Scand J Rheumatol, 40, pp.95~100 (2011)
- Baker JF, "Deficits in muscle mass, muscle density, and modified associations with fat in rheumatoid arthritis", Arthritis Care Res(Hoboken), 66, pp.1612~1618 (2014)
- Abbasi F, "Relationship between obesity, insulin resistance, and coronary heart disease risk", J Am Coll Cardiol, 40, pp.937~943 (2002)
- Panagiotakos DB, "The implication of obesity and central fat on markers of chronic inflammation : the ATTICA study", Atherosclerosis, 183, pp.308~315 (2005)
- Curtis JR, "Influence of obesity, age, and comorbidities on the multi-biomarker disease activity test in rheumatoid arthritis", Semin Arthritis Rheum, 47, pp.472~477 (2018)
- Yoo JJ, "Relationships between body mass index, fat mass, muscle mass, and musculoskeletal pain in community residents", Arthritis Rheumatol, 66, pp.3511~3520 (2014)
- Vidal C, "Association of body mass index categories with disease activity and radiographic joint damage in rheumatoid arthritis : a systematic review and metaanalysis", J Rheumatol, 42, pp.2261~2269 (2015)
- Joharatnam N, "A cross-sectional study of pain sensitivity, disease-activity assessment, mental health, and fibromyalgia status in rheumatoid arthritis", Arthritis Res Ther, 17, pp.11~ (2015)
- Park IY, "Gender-specific associations between fat mass, metabolic syndrome and musculoskeletal pain in community residents : a threeyear longitudinal study", PLoS One, 13, pp.e0200138~ (2018)
- Straub RH, "The complex role of estrogens in inflammation", Endocr Rev, 28, pp.521~574 (2007)
- Dao HH, "Abnormal body composition phenotypes in Vietnamese women with early rheumatoid arthritis", Rheumatology(Oxford), 50, pp.1250~1258 (2011)
- Cho YG, "The relationship between body fat mass and erectile dysfunction in Korean men : Hallym Aging Study", Int J Impot Res, 21, pp.179~186 (2009)