Bożena Targońska-Stępniak1, Maria Majdan. 1. Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, ul. Jaczewskiego 8, Lublin, Poland. bozena.stepniak@am.lublin.pl
Abstract
INTRODUCTION: In patients with rheumatoid arthritis (RA), the loss of body cell mass is observed, known as rheumatoid cachexia. Cachexia is associated with increased morbidity and premature mortality of RA patients. OBJECTIVES: The aim of the study was to assess the effect of chronic inflammation and disease activity on nutritional status in RA patients. PATIENTS AND METHODS: In 140 patients with RA (111 women, 29 men), RA activity was measured using the Disease Activity Score in 28 joints (DAS28) and using the Modified Health Assessment Questionnaire (M-HAQ). The nutritional status was assessed with the following parameters: serum albumin and total cholesterol (TC), body mass index (BMI), hand-grip strength (HGS), and tricipital skinfold thickness. RESULTS: There was a significant association between the parameters of nutritional status and the markers of inflammatory disease activity (number of swollen and tender joints, C-reactive protein, hemoglobin) and physical disability (M-HAQ). Swollen joint count and M-HAQ were inversely correlated with several nutritional parameters. In patients with high disease activity, significantly lower HGS and serum albumin levels were observed. Advanced stages of the disease (erosive and/or long-standing RA) were associated with lower HGS and higher TC levels. CONCLUSIONS: The nutritional status of RA patients is determined by the intensity of chronic inflammatory process observed in the course of the disease and by disease duration.
INTRODUCTION: In patients with rheumatoid arthritis (RA), the loss of body cell mass is observed, known as rheumatoid cachexia. Cachexia is associated with increased morbidity and premature mortality of RApatients. OBJECTIVES: The aim of the study was to assess the effect of chronic inflammation and disease activity on nutritional status in RApatients. PATIENTS AND METHODS: In 140 patients with RA (111 women, 29 men), RA activity was measured using the Disease Activity Score in 28 joints (DAS28) and using the Modified Health Assessment Questionnaire (M-HAQ). The nutritional status was assessed with the following parameters: serum albumin and total cholesterol (TC), body mass index (BMI), hand-grip strength (HGS), and tricipital skinfold thickness. RESULTS: There was a significant association between the parameters of nutritional status and the markers of inflammatory disease activity (number of swollen and tender joints, C-reactive protein, hemoglobin) and physical disability (M-HAQ). Swollen joint count and M-HAQ were inversely correlated with several nutritional parameters. In patients with high disease activity, significantly lower HGS and serum albumin levels were observed. Advanced stages of the disease (erosive and/or long-standing RA) were associated with lower HGS and higher TC levels. CONCLUSIONS: The nutritional status of RApatients is determined by the intensity of chronic inflammatory process observed in the course of the disease and by disease duration.