Background:The problem of sarcopenia (SP) in rheumatoid arthritis (RA) is particularly significant in terms of assessing the risk of fractures, since SP leads to falls, which are an independent risk factor for fractures along with RA and osteoporosis.Objectives:To evaluate the bone mineral density (BMD) and fracture risk in women with RA and SP.Methods:79 women with RA based on the 2010 ACR/EULAR classification criteria were included: 20 (25%) women with confirmed SP (age median 59 [53; 64]) according to EWGSOP2 criteria and 59 (75%) women without SP (age median 60 [55; 67]) (p>0.05). We assessed clinical data: age, body mass index (BMI), disease duration, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), previous medication use including glucocorticoids and methotrexate, muscle strength and function. Dual-energy X-ray absorptiometry (DXA) to measure BMD of lumbar spine (LS), femoral neck (FN) and total hip (TH) was performed. The 10-year probability of major osteoporotic fracture (clinical spine, forearm, hip or shoulder fracture) and the 10-year probability hip fracture was calculated using the Russian version of the FRAX® tool. Statistical analysis was performed using non-parametric methods. All patients signed an informed consent to participate.Results:Median BMD in LS was 0.892 [0.772; 1.024] g/cm2in patients with SP and 0.910 [0.785; 1.028] g/cm2- without SP (p>0.05). There was significant difference between groups in the proximal femur BMD: 0.760 [0.731; 0.826] g/cm2in TH and 0.681 [0.607; 0.703] g/cm2in FN in patients with SP and 0.838 [0.735; 0.921] g/cm2in TH and 0.719 [0.622; 0.804] g/cm2in FN in patients without SP (p=0.009 and p=0.048, respectively). The frequency of osteoporosis was 35% and 22% in patients with and without SP (p>0,05). The 10-year probability of major osteoporotic fracture with / without femoral neck BMD data was 22,0% [17,0; 32,0] / 19,5% [18,5; 22,5 and 13,3% [9,8; 18,5] / 12,8% [9,3; 17,0] in patients with SP and without SP (р<0.05) and the 10-year probability of hip fracture with / without femoral neck BMD data - 3,1% [3,0; 7,5] / 3,1% [2,3; 3,3] and 1,4% [0,9; 2,78] / 0,65 [0,4; 1,7], respectively (р<0.05).Conclusion:There were no differences in the frequency of osteoporosis between patients with SP and without SP, however women with SP had proximal femur BMD less than women without SP. The probability of major osteoporotic fracture and hip fracture was significantly higher in patients with RA and SP compared with patients without SP.Disclosure of Interests:None declared
Mechanical torque measurement in the proximal femur correlates to failure load and bone mineral density ex vivo