Background/Purpose: Sarcopenia is a low-level, smoldering inflammatory state driven by cytokines and oxidative stress. In rheumatoid arthritis (RA) the relationship between sarcopenia and severity of disease as reflected by joint damage (JD) has not been established. The aim of this study was to determine the association between sarcopenia and joint damage in patients with RA.

Methods: We conducted a single center cross-sectional study. All subjects were older than 18 years at diagnosis and met the ACR criteria. We excluded patients with prosthetic or metallic elements, infections, trauma/ recent surgery, cancer, hospitalized, neurological sequelae from stroke, pregnant or weight> 140 kg. Appendicular skeletal muscle mass (ASM) was measured using dual X-ray absorptiometry (DXA), sarcopenia was define as ASM⁄m² less than 5.45 kg⁄m², we assessed physical performance using the Short Physical Performance Battery  (SPPB) and muscle strength of the knee and elbow flexion⁄extension using a digital  dynamometer. A blinded investigator to sarcopenia status determined JD score according to Sharp van der Heidje method. An univariated linear regression model to determine association between sarcopenia and joint damage was applied after that, a multiple regression model, ajusted to age, disease duration, diagnosis delay, DAS28CRP, Fn-HAQ and current doses of  prednisone, was performed to determine persistence of the association. Data was analyzed using SPSS v20.0 .

Results: Ninety three women were evaluated, mean (SD) age was 51.56 (10.21) years, disease duration was 14.12 (8.86), and diagnostic delay was 1.73 (2.28) years, 83% were rheumatoid factor positive.  Fn-HAQ score was 3.15 (1.50) and DAS28-CRP: 3.52 (1.06). The average value of ASM was 13.48 (2.63) kg⁄m². Twenty seven (29%) patients were found to be sarcopenic. Patients with sarcopenia had lower muscle strength and performance. In the multivariate linear regression model sarcopenia was independently associated with JD (β: 0.261, p: 0.031).

Conclusion: Sarcopenia was associated with JD in our female patients with RA independently of other well­ known risk factors for damage. Sarcopenia contributes to physical frailty, an state that distinct from functional disability, contributes indeed to adverse patient outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/sarcopenia-is-associated-with-joint-damage-in-rheumatoid-arthritis-patients-a-cross-sectional-study-in-a-peruvian-population/