Early rheumatoid arthritis and body composition.
OBJECTIVE
RA is associated with joint destruction and cardiovascular diseases (CVDs). Possible predictors for CVD are early changes in body composition. We therefore evaluated whether lean mass of arms and legs (LMAL), total body fat mass (BFM) or truncal fat distribution (TFD) are altered early in RA, and if so, which factors are associated.


METHODS
We included 132 RA patients (95 women) with disease duration of < or =12 months. Disease activity score (DAS28), HAQ, BMI, comorbidity, smoking and medications were recorded. Total and regional lean mass and fat mass were measured with DXA. Data were compared with 132 age- and gender-matched controls, and possibly associated factors were analysed in linear regression models.


RESULTS
LMAL was low in patients for both women and men (P = 0.007 and <0.001, respectively). BMI (P = 0.012), BFM (P = 0.014) and TFD (P < 0.001) were higher than expected in RA women. In bivariate analyses, all adjusted for age and current smoking, disease duration was independently associated with low LMAL in women (P = 0.021). High BFM was associated with HAQ x disease duration in men (P = 0.033) and DAS28 in women (P = 0.011). High TFD was associated with a history of diabetes or CVD in men with RA (P = 0.005).


CONCLUSIONS
Low LMAL, high BFM and high TFD are present in early RA patients. The long-term significant consequences of these abnormalities need to be determined.
Book
Christina
C
Department of Rheumatology, Malmö University Hospital, SE-205 02, Malmö, Sweden. christina.book@med.lu.se
Karlsson
Magnus K
MK
Akesson
Kristina
K
Jacobsson
Lennart T H
LT
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000503:physiopathology*; D001823:Body Composition; D050218:Body Fat Distribution; D015992:Body Mass Index; D015986:Confounding Factors, Epidemiologic; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors
D018501:Antirheumatic Agents; D005938:Glucocorticoids