Comment on: Periarticular osteoporosis: a useful feature in the diagnosis of early rheumatoid arthritis? Reliablity and validity in a cross-sectional diagnostic study using dual-energy X-ray absorptiometry: Reply

Aim of the study was to clarify the body composition in patients with early rheumatoid arthritis before starting therapy with synthetic basic anti-inflammatory drugs, genetically engineered biological drugs and glucocorticoids using dual-energy X-ray absorptiometry and to assess the effect of inflammation and metabolic syndrome on body composition.Material and methods. The study included 37 patients (31 women and 6 men) with early rheumatoid arthritis. The control group consisted of 19 healthy donors without rheumatic diseases. Patients with rheumatoid arthritis and the control group were measured by waist size, height and weight, and body mass index was calculated. Body composition was determined by means of dual-energy X-ray absorptiometry using the “Whole Body” program on the HOLOGIC device (USA). The presence of metabolic syndrome was assessed according to the criteria of the International Diabetes Federation (IDF).Results. Patients with early rheumatoid arthritis had less lean tissue mass, which was negatively correlated with inflammatory markers (ESR and C-reactive protein levels). Overweight and obesity were diagnosed in 24% and 27% of patients with early rheumatoid arthritis, respectively. Patients with rheumatoid arthritis and metabolic syndrome had a higher body weight, body mass index, waist size, and adipose tissue mass than patients without metabolic syndrome. With the help of instrumental methods, it is shown that in rheumatoid arthritis there is a redistribution of fat mass in the body, its predominant accumulation in the trunk area and a parallel decrease in the volume of muscle tissue.Conclusion. Rheumatoid inflammation and metabolic syndrome affect body composition of patients with early rheumatoid arthritis before the start of antirheumatic therapy.

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Measurement of hand bone mineral density in early rheumatoid arthritis using dual energy X-ray absorptiometry

International Journal of Rheumatic Diseases ◽

10.1111/j.1756-185x.2010.01485.x ◽

2010 ◽

Vol 13 (3) ◽

pp. 230-234 ◽

Cited By ~ 5

Author(s):

Catherine L. HILL ◽

Christopher G. SCHULTZ ◽

Rodney WU ◽

Barry E. CHATTERTON ◽

Leslie G. CLELAND

Keyword(s):

Rheumatoid Arthritis ◽

Bone Mineral Density ◽

Bone Mineral ◽

Early Rheumatoid Arthritis ◽

Dual Energy ◽

Mineral Density ◽

X Ray

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Hand bone loss measured by digital X-ray radiogrammetry is a predictor of joint damage in early rheumatoid arthritis

Scandinavian Journal of Rheumatology ◽

10.1080/03009740902939376 ◽

2009 ◽

pp. 1-8

Author(s):

K. Forslind ◽

A. Boonen ◽

K. Albertsson ◽

I. Hafstrom ◽

B. Svensson ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Bone Loss ◽

Early Rheumatoid Arthritis ◽

Joint Damage ◽

X Ray

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AB0267 BODY COMPOSITION IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2318 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1432.2-1432

Author(s):

N. Toroptsova ◽

O. Dobrovolskaya ◽

N. Demin ◽

L. Shornikova

Keyword(s):

Rheumatoid Arthritis ◽

Body Composition ◽

Muscle Mass ◽

Dual Energy ◽

X Ray ◽

T Score ◽

Osteosarcopenic Obesity ◽

The Mean ◽

Total Fat ◽

Appendicular Muscle Mass

Background:Rheumatoid arthritis (RA) is a complex inflammatory disease that modifies body composition. Using the dual-energy x-ray absorptiometry (DXA) in RA patients could be a method for body composition changes detection.Objectives:To study the body composition using DXA in patients with RA.Methods:The study involved 79 women with RA, median age 60 [55; 65] years. The bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry using «Discovery A» (Hologic, USA). Assessment of body composition was carried out, using the program «Whole body». Sarcopenia (SP) was diagnosed as a decrease in appendicular mass index (AMI) <6.0 kg/m2. Osteoporosis (OP) was diagnosed as a decrease in T-score <-2.5 SD. Osteosarcopenia was determined when T-score was <-1.0 SD, AMI was <6.0 kg/m2, osteosarcopenic obesity - T-score was <-1.0 SD, AMI was <6.0 kg/m2and total fat was >35%.Results:The mean duration of RA was 9 [3; 11] years. The mean body mass index (BMI) was 27.6±4.8 kg/m2. Disease activity score in 28 joints-erythrocyte sedimentation rate was 4.5±1.3 points for the group. 39 (49.3%) patients used oral glucocorticoids continuously. Appendicular muscle mass and AMI were on average 17.8±3.0 kg and 6.8±1.0 kg/m2, respectively. AMI <6 kg/m2was detected in 20 (25.3%) patients. 56 (70.9%) women with RA had total fat > 35%, while only 22 (27.8%) of women with RA had obesity according to BMI (BMI >30 kg/m2). Isolated OP was found in 13 (16.5%), osteosarcopenia in 7 (8.9%) and osteosarcopenic obesity in 13 (16.5%) patients RA. No cases with isolated sarcopenia or sarcopenic obesity were detected. Only 3 (3.8%) patients did not have appendicular muscle mass, AMI and BMD decrease and overfat or obesity.Conclusion:About 97% women with RA had abnormal body composition phenotype: 16,5% - OP, 8.9% -osteosarcopenia, 16,5% - osteosarcopenic obesity and 54,4% - overfat.Disclosure of Interests:None declared

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Temporomandibular disorders in patients with early rheumatoid arthritis and at-risk individuals in the Dutch population: a cross-sectional study

RMD Open ◽

10.1136/rmdopen-2020-001485 ◽

2021 ◽

Vol 7 (1) ◽

pp. e001485

Author(s):

Johanna M Kroese ◽

Catherine M C Volgenant ◽

Wim Crielaard ◽

Bruno Loos ◽

Dirkjan van Schaardenburg ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

At Risk ◽

Early Rheumatoid Arthritis ◽

Temporomandibular Disorders ◽

Self Report ◽

Joint Disease ◽

Control Group ◽

Healthy Controls ◽

Cross Sectional ◽

Pain Diagnosis

ObjectiveTo evaluate the prevalence of temporomandibular disorders (TMD) in patients with early rheumatoid arthritis (ERA) and individuals at-risk of RA.Methods150 participants were recruited in three groups (50 per group): (1) patients with ERA (2010 EULAR criteria) (2) at-risk individuals and (3) healthy controls. All participants were tested for seropositivity of rheumatoid factor and anticitrullinated protein antibodies. A possible TMD diagnosis was determined according to the standardised and validated diagnostic criteria for TMD (DC/TMD) in five categories: myalgia, arthralgia, articular disc displacement, degenerative joint disease and headache attributed to TMD. Results were tested for the prevalence of TMD (all categories combined) and TMD pain (myalgia and/or arthralgia). To investigate a possible role for bruxism, a probable sleep and/or awake bruxism diagnosis was determined based on self-report and several clinical features.ResultsThe prevalence of any TMD diagnosis did not differ between the three groups. However, at-risk individuals more often had a TMD-pain diagnosis than healthy controls (p=0.046). No such difference was found between the ERA group and the control group. However, within the ERA group, seronegative patients had a TMD-pain diagnosis more often than seropositive patients (4/12 (33%) vs 3/38 (8%), p=0.048). Participants with a TMD-pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD-pain diagnosis.ConclusionThe prevalence of TMD pain is increased in individuals at-risk of RA and seronegative ERA patients, and is associated with bruxism signs and symptoms. These results suggest that health professionals should be alert to TMD pain in these groups.

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