Relevance of the new pre-cachexia and cachexia definitions for patients with rheumatoid arthritis.
OBJECTIVE
The recently proposed definitions of 'pre-cachexia' and 'cachexia' might offer new possibilities for the detection of malnutrition in patients with rheumatoid arthritis (RA).


METHODS
The prevalence of different components of nutritional status and the compiled definitions of 'precachexia' and 'cachexia' were measured in a cohort of 103 patients with moderately active RA. Nutritional status was determined by measuring unintentional weight loss, BMI, and muscle strength. Bio-electrical Impedance Analysis (BIA) was used to determine fat free mass index (FFMI) and fat mass index. In addition, appetite, pain, fatigue, and inflammatory activity were assessed. The prevalence of 'pre-cachexia' and 'cachexia' was calculated from different combinations of these parameters.


RESULTS
20% of the study population had a low FFMI (<10th percentile), and 95% had a decreased muscle strength ( < lowest tertile). Weight loss and loss of appetite, both essential elements in the newly proposed (pre-)cachexia definitions, were uncommon. The prevalence of 'pre-cachexia' and 'cachexia' was both 1% (n = 1).


CONCLUSIONS
In spite of altered body composition and impaired body function, the recently proposed definitions of both 'pre-cachexia' and 'cachexia' were unable to identify and diagnose impaired nutritional status in RA patients mainly because of low prevalences of weight loss and decreased appetite.
Department of Nutrition and Dietetics, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. m.vanbokhorst@vumc.nl
Marian A E
MA
van Bokhorst-de van der Schueren
Nicole P C
NP
Konijn
Irene E M
IE
Bultink
Willem F
WF
Lems
Carrie P
CP
Earthman
Lilian H D
LH
van Tuyl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology*; D001823:Body Composition; D015992:Body Mass Index; D002100:Cachexia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009426:Netherlands; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D015431:Weight Loss / Q000502:physiology