Body composition and nutritional status in women with rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with a predominant joint lesion, as well as bones and muscles. The frequency of pathological phenotypes of body composition in patients with RA exceeds that in healthy individuals. Numerous factors can affect the body composition of RA patients, related to both the disease itself and lifestyle factors.

Aim: to assess the nutritional status and its relationship with phenotypes of body composition in women with rheumatoid arthritis.

Materials and methods: 91 women (average age 60.0 [51.0; 67.0] years) with RA underwent clinical and laboratory examination, dual-energy X-ray absorptiometry. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) questionnaire.

Results: in total, the risk of malnutrition and malnutrition was identified in 44% of the examined patients. Correlations were established between the nutritional status by MNA and total and appendicular muscle mass (r=0.30, p=0.003 and r=0.35, p=0.001, respectively), between body mass index and bone mineral density (BMD) of lumbar spine (r=0.23, p=0.030), BMD of femoral neck (r=0.30, p=0.004) and the BMD of total hip (r=0.33, p=0.001). Multivariate analysis revealed the association of sarcopenic phenotype with nutritional status by MNA <24 points (OR 2.85 (95%CI 1.05–7.69), p=0.039), daily calcium intake <500 mg/day (OR 2.74 (95%CI 1.01–7.45), p=0.048) and upper arm circumference <25 cm (ОR 6.02 (95%CI 1.48–24.53), p=0.013). The obesity phenotype was associated with the risk of malnutrition (ОR 4.97 (95%CI 1.33–18.54), p=0.018) and upper arm circumference >25 cm (ОR 4.07 (95%CI 1.21–13.77), p=0.024). The phenotype of osteoporosis was associated with age >55 years (ОR 7.81 (95%CI 2.12–28.80), p=0.002), nutritional status by MNA <24 points (ОR 1.45 (95%CI 1.06–1.96), p=0.019) and sarcopenic phenotype (ОR 4.57 (95% CI 1.38–15.13), p=0.013).

Conclusion: the frequency of low nutritional status was 44% among the examined women with RA. It was revealed that all pathological phenotypes of body composition were associated with a reduced nutritional status according to MNA.

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