Joshua F Baker1,2, Jin Long3,4, Sogol Mostoufi-Moab3,4, Michele Denburg3,4, Erik Jorgenson3,4, Prerna Sharma3,4, Babette S Zemel3,4, Elena Taratuta3,4, Said Ibrahim3,4, Mary B Leonard3,4. 1. From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA. bakerjo@uphs.upenn.edu. 2. J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University. bakerjo@uphs.upenn.edu. 3. From the Division of Rheumatology, and Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center; Department of Epidemiology, Biostatistics, and Informatics, and the Department of Radiology, University of Pennsylvania; Department of Pediatrics, and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Stanford University, Palo Alto, California, USA. 4. J.F. Baker, MD, MSCE, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center, Division of Rheumatology, and the Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; J. Long, PhD, Department of Pediatrics, Stanford University; S. Mostoufi-Moab, MD, MSCE, Department of Pediatrics, Children's Hospital of Philadelphia; M. Denburg, MD, MSCE, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Department of Pediatrics, and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia; E. Jorgenson, MPH, Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania; P. Sharma, BA, Division of Rheumatology, Corporal Michael J. Crescenz VA Medical Center; B.S. Zemel, PhD, Department of Pediatrics, Children's Hospital of Philadelphia; E. Taratuta, MD, Department of Radiology, University of Pennsylvania; S. Ibrahim, MD, MPH, MBA, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center; M.B. Leonard, MD, MSCE, Department of Pediatrics, Stanford University.
Abstract
OBJECTIVE: Rheumatoid arthritis (RA) is associated with muscle loss, osteoporosis, and fracture. We examined associations between skeletal muscle mass, strength, and quality and trabecular and cortical bone deficits in patients with RA and healthy controls. METHODS: Participants, ages 18-75 years, completed whole-body dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT) of the tibia to quantify appendicular lean mass and fat mass indices (ALMI, FMI), muscle density at the lower leg, trabecular bone density, and cortical bone thickness. Age-, sex-, and race-specific Z scores were calculated based on distributions in controls. Associations between body composition and pQCT bone outcomes were assessed in patients with RA and controls. Linear regression analyses assessed differences in bone outcomes after considering differences in body mass index (BMI) and body composition. RESULTS: The sample consisted of 112 patients with RA (55 men) and 412 controls (194 men). Compared to controls, patients with RA had greater BMI Z score (p < 0.001), lower ALMI Z score after adjustment for FMI (p = 0.02), lower muscle strength Z score (p = 0.01), and lower muscle density Z score (p < 0.001). Among RA, ALMI Z scores were positively associated with trabecular density [β: 0.29 (0.062-0.52); p = 0.01] and cortical thickness [β: 0.33 (0.13-0.53; p = 0.002]. Associations were similar in controls. Bone outcomes were inferior in patients with RA after adjusting for BMI, but similar to controls when adjusting for body composition. Radiographic damage and higher adiponectin levels were independently associated with inferior bone outcomes. CONCLUSION: Patients with RA exhibit deficits in cortical bone structure and trabecular density at the tibia and a preserved functional muscle-bone unit. A loss of mechanical loading may contribute to bone deficits.
OBJECTIVE:Rheumatoid arthritis (RA) is associated with muscle loss, osteoporosis, and fracture. We examined associations between skeletal muscle mass, strength, and quality and trabecular and cortical bone deficits in patients with RA and healthy controls. METHODS:Participants, ages 18-75 years, completed whole-body dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT) of the tibia to quantify appendicular lean mass and fat mass indices (ALMI, FMI), muscle density at the lower leg, trabecular bone density, and cortical bone thickness. Age-, sex-, and race-specific Z scores were calculated based on distributions in controls. Associations between body composition and pQCT bone outcomes were assessed in patients with RA and controls. Linear regression analyses assessed differences in bone outcomes after considering differences in body mass index (BMI) and body composition. RESULTS: The sample consisted of 112 patients with RA (55 men) and 412 controls (194 men). Compared to controls, patients with RA had greater BMI Z score (p < 0.001), lower ALMI Z score after adjustment for FMI (p = 0.02), lower muscle strength Z score (p = 0.01), and lower muscle density Z score (p < 0.001). Among RA, ALMI Z scores were positively associated with trabecular density [β: 0.29 (0.062-0.52); p = 0.01] and cortical thickness [β: 0.33 (0.13-0.53; p = 0.002]. Associations were similar in controls. Bone outcomes were inferior in patients with RA after adjusting for BMI, but similar to controls when adjusting for body composition. Radiographic damage and higher adiponectin levels were independently associated with inferior bone outcomes. CONCLUSION:Patients with RA exhibit deficits in cortical bone structure and trabecular density at the tibia and a preserved functional muscle-bone unit. A loss of mechanical loading may contribute to bone deficits.
Entities:
Keywords:
BODY COMPOSITION; BONE STRUCTURE; MUSCLE; RHEUMATOID ARTHRITIS
Authors: Megan P Rothney; Yi Xia; Wynn K Wacker; Francois-Pierre Martin; Maurice Beaumont; Serge Rezzi; Vittorio Giusti; David L Ergun Journal: Obesity (Silver Spring) Date: 2013-01 Impact factor: 5.002
Authors: Andy K O Wong; Karen A Beattie; Kevin K H Min; Zamir Merali; Colin E Webber; Christopher L Gordon; Alexandra Papaioannou; Angela M W Cheung; Jonathan D Adachi Journal: J Clin Densitom Date: 2014-08-13 Impact factor: 2.617
Authors: Jon T Giles; Matthew Allison; Roger S Blumenthal; Wendy Post; Allan C Gelber; Michelle Petri; Russell Tracy; Moyses Szklo; Joan M Bathon Journal: Arthritis Rheum Date: 2010-11
Authors: Joshua F Baker; Joan Marie Von Feldt; Sogol Mostoufi-Moab; Woojin Kim; Elena Taratuta; Mary B Leonard Journal: J Rheumatol Date: 2015-09-01 Impact factor: 4.666
Authors: Anna Darelid; Claes Ohlsson; Robert Rudäng; Jenny M Kindblom; Dan Mellström; Mattias Lorentzon Journal: J Bone Miner Res Date: 2010-03 Impact factor: 6.741
Authors: Joshua F Baker; Sogol Mostoufi-Moab; Jin Long; Babette Zemel; Said Ibrahim; Elena Taratuta; Mary B Leonard Journal: Arthritis Care Res (Hoboken) Date: 2018-11-02 Impact factor: 4.794
Authors: Joshua F Baker; Sogol Mostoufi-Moab; Jin Long; Elena Taratuta; Mary B Leonard; Babette Zemel Journal: Arthritis Care Res (Hoboken) Date: 2021-03 Impact factor: 4.794