[Physical activity and nutritional status in women with rheumatoid arthritis and sarcopenic phenotype of body composition].

AIM: To assess physical activity (PA) and nutritional status and their relationship with the sarcopenic phenotype of body composition in women with rheumatoid arthritis (RA). MATERIAL AND METHODS: 104 women (mean age 59.5±8.7 years) with RA underwent clinical and laboratory examination, dual-energy X-ray absorptiometry. The level of PA and nutritional status were assessed using the International Physical Activity Questionnaire (IPAQ) and Mini Nutritional Assessment (MNA) questionnaires, respectively. RESULTS: Sarcopenic phenotype was diagnosed in 37.1% of patients. Moderate and low PA levels were detected in 44.2 and 7.8%, respectively, risk of malnutrition - in 50% of persons. In multivariate logistic regression analysis, factors associated with the sarcopenic phenotype were determined: the frequency of vigorous PA<3 times a week [odds ratio - OR 5.12 (95% confidence interval - CI 1.15-22.94); p=0.032], walking <1 hour a day [OR 4.98 (95% CI 1.14-21.74); p=0.033], risk of malnutrition by MNA [OR 4.13 (95% CI 1.12-15.32); p=0.034], body mass index <25 kg/m2 [OR 8.11 (95% CI 1.86-35.32); p=0.006] and daily calcium intake <500 mg [OR 4.62 (95% CI 1.06-20.08); p=0.041]. CONCLUSION: 52% of women with RA had moderate оr low PA levels, and 50% of patients were at risk of malnutrition. The risk of sarcopenic phenotype associated with a low frequency of vigorous PA, low walking time, risk of malnutrition, body mass index <25 kg/m2 and insufficient calcium intake.

[Phenotypes of body composition, physical performance and quality of life in women with rheumatoid arthritis].

AIM: To evaluate the frequency of different body composition phenotypes, physical performance (PP) and their relationship with quality of life in women with rheumatoid arthritis (RA). MATERIALS AND METHODS: The study included 157 women (average age 58.68.8 years) with RA. Clinical and laboratory examination, dual-energy X-ray absorptiometry, quality of life assessment according to the questionnaires EQ-5D (European Quality of Life Questionnaire), HADS (Hospital Anxiety and Depression Scale) and RAID (Rheumatoid Arthritis Impact of Disease), determination of muscle strength and the PP of skeletal muscles were carried out. RESULTS: Osteoporotic, sarcopenic and osteosarcopenic phenotypes of body composition were identified in 27 (17%), 16 (10%) and 16 (10%) patients, respectively; 139 (88.5%) people had low muscle strength, and 96 (61.1%) had reduced PP. Quality of life according to the EQ-5D index and RAID, the severity of depression according to HADS in women with different phenotypes of body composition did not differ. Women with osteosarcopenic phenotype had worse indicators for EQ-5D-VAS (VAS visual analog scale), and patients with sarcopenic phenotype had more severe anxiety according to the HADS questionnaire compared to those with normal phenotype (p=0.014 and p=0.027, respectively). The quality of life according to all questionnaires was significantly worse in patients with reduced PP. CONCLUSION: Pathological phenotypes of body composition were found in 37% of RA patients. A decrease in muscle strength was revealed in 88.5%, and a low PP in 61.1% of patients. The relationship between quality of life and body composition has not been established, at the same time quality of life associated with the PP of skeletal muscles.

[Vitamin D status in women with rheumatoid arthritis: frequency of hypovitaminosis, associations with disease activity, body composition and comorbidity].

AIM: To evaluate the status of vitamin D in women with rheumatoid arthritis (RA) and establish its associations with comorbidity, disease activity, and body composition components. MATERIALS AND METHODS: 86 women with RA (average age 58.18.5 years) were enrolled in the study. We analyzed the relationship of vitamin D levels with clinical and laboratory parameters and with the results of two-energy x-ray absorptiometry. MannWhitney or KruskalWallis, 2 and Spearman tests were performed using Statistica for Windows 10.0 (StatSoft Inc., USA). RESULTS: Vitamin D level was 22.4 [17.8; 27.3] ng/ml: deficiency was detected in 33%, and insufficiency in 46% of women with RA. Only 41% of patients with low vitamin D levels received supplements of cholecalciferol, while only 9% in a sufficient dose. 25(OH)D level was significantly lower in RA patients with sarcopenia, obesity, high activity according to DAS28 and in those who did not receive vitamin D supplements. There werent differences in 25(OH)D levels among subgroups of patient according to age, fertility, BMD status, comorbidity index, RA duration, ESR and CRP levels, medical therapy performed. CONCLUSION: 79% of patients with RA had low levels of vitamin D, while less than half of them received additional cholecalciferol supplements. Low vitamin D levels in RA patients were associated with high disease activity, sarcopenia, and obesity.

[Frequency of sarcopenia and factors associated with lean mass in women with rheumatoid arthritis].

AIM: To evaluate the frequency of sarcopenia (SP) according to EWGSOP2 criteria and factors associated with low lean mass in women with rheumatoid arthritis (RA). MATERIALS AND METHODS: 79 women (aged 4075 years) with RA were enrolled in the study. We analyzed clinical data: age, body mass index (BMI), disease duration, methotrexate use, glucocorticoid use, anthropometric measurements, C-reactive protein level, disease activity score in 28 joints-erythrocyte sedimentation rate, bone mineral density (BMD) of the lumbar spine, femur neck, total hip and body composition by Dual energy X-ray absorptiometry. Also, muscle strength and functional tests were performed. We analyzed the correlation between disease parameters and low lean mass with the Spearman method. RESULTS: 73 (92%) patients had low muscle strength, 20 (25%) patients had low muscle strength and low lean mass, among them 9 (11%) also had functional disability. There was no correlation between the age of patients and the presence of SP, while the duration of RA in women with SP was significantly greater (p=0.006). There were significant correlations between lean mass and body mass index, glucocorticoids used, methotrexate doses, creatinine and urea acid serum concentration, bone mineral density and falls number. CONCLUSION: According EWGSOP2 confirmed sarcopenia was found in 25% RA patients, among them 11% women had severe sarcopenia. Lean mass correlated with the factors related to the disease itself and some general clinical parameters, which requires further study.