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Correlates of physical activity in adults with spondyloarthritis and rheumatoid arthritis: a systematic review. Rheumatol Int 2022; 42:1693-1713. [PMID: 35672508 PMCID: PMC9439989 DOI: 10.1007/s00296-022-05142-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/30/2022] [Indexed: 11/25/2022]
Abstract
Physical activity (PA) is a primary non-pharmacological treatment option for those living with rheumatoid arthritis (RA) and spondyloarthritis (SpA). The aim of this systematic literature review was to summarize and present an updated synthesis of the factors associated with PA in the RA and SpA populations. A tailored search of PubMed (inc. Medline), Web of Science, Embase, APA PsycNET, and Scopus was conducted for research published between 2004 and June 2019. Methodological quality was assessed using The National Institutes of Health (NIH) Quality Assessment Tools for Observational Cohort and Cross-sectional Studies, Case–Control Studies, and Controlled Intervention Studies. Forty RA and eleven SpA articles met the inclusion criteria. Methodological quality was generally fair to good, with two RA studies rated as poor. Correlates are discussed in the sociodemographic, physical, psychological, social, and environmental categories. Environmental factors were not measured in any RA study. In individuals living with RA, consistent positive associations were found between PA and high-density lipoprotein, self-efficacy, and motivation. Consistent negative associations were found for functional disability and fatigue. In individuals with SpA, consistent positive associations were found between PA and quality of life, and consistent negative associations with functional disability. Physical and psychological factors are most consistently related with PA parameters in those living with RA and SpA. Many variables were inconsistently studied and showed indeterminant associations. Studies with prospective designs are needed to further understand the factors associated with PA in these populations, especially in those living with SpA.
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Cai W, Tang X, Pang M. Prevalence of Metabolic Syndrome in Patients With Rheumatoid Arthritis: An Updated Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:855141. [PMID: 35462993 PMCID: PMC9024100 DOI: 10.3389/fmed.2022.855141] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Rheumatoid arthritis (RA) due to systemic inflammation and insulin resistance increases the risk of cardiovascular disease and reduces life expectancy. In order to develop cardiac death prevention strategies, it is necessary to estimate the prevalence of metabolic syndrome (MetS) in these patients. Methods This systematic review and meta-analysis was performed to estimate the prevalence of MetS among patients with RA. International databases (i.e., Scopus, PubMed, Web of Science, and Google Scholar) were searched during the period of October 1 and October 10, 20121. Heterogeneity among the included studies was assessed through the Cochrane Q test statistics and I2 test. Finally, a random-effects meta-analysis model was computed to estimate the pooled prevalence of MetS. Results Sixty-one articles with 96 groups and a sample size of 13,644 people were analyzed. The pooled prevalence of MetS was 32% (95% CI: 29.6–34.4). The highest prevalence of MetS is related to studies conducted in Asia (32.7%, 95% CI: 29–36.3) and Europe (32.7%, 95% CI: 27.5.37.9) and the lowest Prevalence was also related to studies conducted in Africa (28%, 95% CI: 28.8–32.2). The prevalence of MetS in men was 33% (95% CI: 26–39) and 34% (95% CI: 29–40) in women. Findings by diagnostic criteria showed that the highest and lowest prevalence of MetS was related to ATP III (37.5%, 95% CI: 30.9–44.2) and EGIR (14.4%, 95% CI: 10.5–18.5), respectively. Conclusions MetS is highly prevalent in patients with RA and identification of high-risk patients is necessary to prevent cardiovascular mortality.
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Affiliation(s)
- Wei Cai
- Pediatric Department, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
- *Correspondence: Wei Cai
| | - Xuemi Tang
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Min Pang
- Department of Rheumatology and Immunology, Children's Hospital of Chongqing Medical University, Chongqing, China
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Cruz-Jentoft AJ, Romero-Yuste S, Chamizo Carmona E, Nolla JM. Sarcopenia, immune-mediated rheumatic diseases, and nutritional interventions. Aging Clin Exp Res 2021; 33:2929-2939. [PMID: 33566325 PMCID: PMC8595168 DOI: 10.1007/s40520-021-01800-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/15/2021] [Indexed: 12/27/2022]
Abstract
Introduction Sarcopenia is defined by a loss of muscle mass and function associated with mortality, decreased physical performance, falls, and disability. Since chronic inflammation and decreased physical activity are risk factors for developing sarcopenia, it is critical to assess the role of sarcopenia in immune-mediated rheumatic diseases (IMRDs). Moreover, nutritional interventions are emerging as key modifiable and affordable options to improve physical performance in sarcopenia. Objective The aim of this review is to critically summarize current information on the evidence linking nutritional interventions and sarcopenia in IMRDs. Methods The search and selection of articles was performed in Medline, Dimensions.ai, Google Scholar, Cochrane Library, Epistemonikos, and Trip Database. The results were clustered into three areas: sarcopenia and IMRDs, sarcopenia and biological disease-modifying antirheumatic drugs (bDMARDs), and nutritional interventions for sarcopenia. Findings Several cross-sectional studies have shown a higher prevalence of sarcopenia in IMRDs, such as rheumatoid arthritis. Although not fully established, evidence linking sarcopenia and other IMRDs (ankylosing spondylitis and systemic sclerosis) has been also described. For secondary sarcopenia prevention and treatment, bDMARDs’ administration proved efficacy in patients with rheumatoid arthritis. Furthermore, there is growing evidence linking nutrition to the prevention and treatment of sarcopenia. Evidence linking unfavourable results in nutritional risk assessment, insufficient intake of protein, vitamin D, antioxidant nutrients, and long-chain polyunsaturated fatty acids and sarcopenia have been reported. Conclusion Given that sarcopenia and IMRDs have strong links, further research is needed to improve patient care.
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Letarouilly JG, Flipo RM, Cortet B, Tournadre A, Paccou J. Body composition in patients with rheumatoid arthritis: a narrative literature review. Ther Adv Musculoskelet Dis 2021; 13:1759720X211015006. [PMID: 34221129 PMCID: PMC8221676 DOI: 10.1177/1759720x211015006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/13/2021] [Indexed: 01/09/2023] Open
Abstract
There is growing interest in the alterations in body composition (BC) that accompany rheumatoid arthritis (RA). The purpose of this review is to (i) investigate how BC is currently measured in RA patients, (ii) describe alterations in body composition in RA patients and (iii) evaluate the effect on nutrition, physical training, and treatments; that is, corticosteroids and biologic Disease Modifying Anti-Rheumatic Disease (bDMARDs), on BC in RA patients. The primary-source literature for this review was acquired using PubMed, Scopus and Cochrane database searches for articles published up to March 2021. The Medical Subject Headings (MeSH) terms used were 'Arthritis, Rheumatoid', 'body composition', 'sarcopenia', 'obesity', 'cachexia', 'Absorptiometry, Photon' and 'Electric Impedance'. The titles and abstracts of all articles were reviewed for relevant subjects. Whole-BC measurements were usually performed using dual energy x-ray absorptiometry (DXA) to quantify lean- and fat-mass parameters. In RA patients, lean mass is lower and adiposity is higher than in healthy controls, both in men and women. The prevalence of abnormal BC conditions such as overfat, sarcopenia and sarcopenic obesity is significantly higher in RA patients than in healthy controls; these alterations in BC are observed even at an early stage of the disease. Data on the effect treatments on BC in RA patients are scarce. In the few studies published, (a) creatine supplementation and progressive resistance training induce a slight and temporary increase in lean mass, (b) exposure to corticosteroids induces a gain in fat mass and (c) tumour necrosis factor alpha (TNFα) inhibitors might be associated with a gain in fat mass, while tocilizumab might be associated with a gain in lean mass. The available data clearly demonstrate that alterations in BC occur in RA patients, but data on the effect of treatments, especially bDMARDs, are inconsistent and further studies are needed in this area.
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Affiliation(s)
- Jean-Guillaume Letarouilly
- University of Lille F-59000 Lille, CHU Lille F-59000 Lille, France; University of Littoral Côte d'Opale F-62200 Boulogne-sur-Mer, France; Marrow Adiposity and Bone Lab - MABLab ULR4490Lille, France
| | - René-Marc Flipo
- Department of Rheumatology, University of Lille, CHU Lille, F-59000 Lille, France
| | - Bernard Cortet
- University of Lille F-59000 Lille, CHU Lille F-59000 Lille, France; University of Littoral Côte d'Opale F-62200 Boulogne-sur-Mer, France; Marrow Adiposity and Bone Lab - MABLab ULR4490Lille, France
| | - Anne Tournadre
- University of Clermont Auvergne, CHU Clermont-Ferrand, UNH-UMR 1019, INRA Department of Rheumatology, F-63003 Clermont-Ferrand, France
| | - Julien Paccou
- MABlab ULR 4490, Department of Rheumatology, CHU Lille, 2, Avenue Oscar Lambret - 59037 Lille Cedex
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The Effect of TNF and Non-TNF-Targeted Biologics on Body Composition in Rheumatoid Arthritis. J Clin Med 2021; 10:jcm10030487. [PMID: 33573047 PMCID: PMC7866419 DOI: 10.3390/jcm10030487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/18/2021] [Accepted: 01/24/2021] [Indexed: 12/28/2022] Open
Abstract
Rheumatoid arthritis (RA) is associated with a decrease in lean mass and stability or even an increase in fat and ectopic adipose tissue. A few data are available on body composition changes under treatment, and data are still controversial. Body composition was assessed before initiation of biologic disease-modifying antirheumatic drug (bDMARD) and after 6 and 12 months of stable treatment. Eighty-three RA patients were included (75% of women, mean age 58.5 ± 10.8 years) of whom 47 patients treated with TNF inhibitor (TNFi), 18 with non-TNF-targeted biologic (Non-TNFi), and 18 with conventional DMARD (cDMARD) alone. In the TNFi group, total lean mass, fat-free mass index, and skeletal muscle mass index significantly increased at 1 year. An increase in subcutaneous adipose tissue (SAT) without change for the visceral or body fat composition was associated. These changes were associated with an improvement in strength and walking test. In non-TNFi or cDMARD groups, no significant changes for body composition or muscle function were observed at 1 year. However, no significant differences for treatment x time interaction were noted between group treatments. In active RA patients starting first bDMARD, treatment with TNFi over 1 year was associated with favorable changes of the body composition and muscle function.
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Maréchal R, Ghachem A, Prud'homme D, Rabasa-Lhoret R, Dionne IJ, Brochu M. Physical activity energy expenditure and fat-free mass: relationship with metabolic syndrome in overweight or obese postmenopausal women. Appl Physiol Nutr Metab 2020; 46:389-396. [PMID: 33080144 DOI: 10.1139/apnm-2020-0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Menopause transition is associated with detrimental changes in physical activity, body composition, and metabolic profile. Although physical activity energy expenditure (PAEE) is inversely associated with metabolic syndrome (MetS) in individuals at higher risk of cardiovascular disease, the association is unknown in low-risk individuals. The aim of the study was to investigate the association between PAEE and MetS (prevalence and severity) in inactive overweight or obese postmenopausal women with a low Framingham Risk Score (<10%). Cross-sectional data of 126 participants were divided into quartiles based on PAEE (Quartile (Q)1 = lowest PAEE) while fat-free mass (FFM) and fat mass were measured by dual-energy X-ray absorptiometry. MetS prevalence was significantly different between Q1 and Q4 (37.9% vs 13.3%, p = 0.03). After controlling for potential confounders, MetS severity was negatively associated with PAEE (B = -0.057, p < 0.01) and positively with FFM (B = 0.038, p < 0.001). Moderation analyses indicated that a greater FFM exacerbated the association between PAEE and MetS severity in Q1 and Q2 (PAEE × FFM; B = -0.004; p = 0.1). Our results suggest that displaying a low FRS and lower PAEE increase MetS prevalence and severity. In addition, greater FFM interacts with lower PAEE to worsens MetS severity, while higher PAEE lessened this effect. Novelty: Inactive individuals displaying higher daily PAEE also have a lower MetS prevalence. Greater FFM is associated with a worse MetS severity where a higher PAEE mitigated this deleterious effect in our cohort.
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Affiliation(s)
- René Maréchal
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Ahmed Ghachem
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada
| | - Denis Prud'homme
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,Institut du Savoir Montfort, Ottawa, ON K1K 0T2, Canada
| | - Rémi Rabasa-Lhoret
- Department of Nutrition, Faculty of Medicine, University of Montreal, Montréal, QC H3T 1A8, Canada.,Institut de Recherche Cliniques de Montréal (IRCM), Montréal, QC H2W 1R7, Canada
| | - Isabelle J Dionne
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
| | - Martin Brochu
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC J1H 4C4, Canada.,Faculty of Physical Activity Sciences, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada
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Santo RC, Silva JM, Lora PS, Moro ALD, Freitas EC, Bartikoski BJ, Andrade NP, Palominos PE, Hax V, Fighera TM, Spritzer PM, Brenol CV, Chakr RM, Filippin LI, Baker JF, Xavier RM. Cachexia in patients with rheumatoid arthritis: a cohort study. Clin Rheumatol 2020; 39:3603-3613. [PMID: 32447598 DOI: 10.1007/s10067-020-05119-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/13/2020] [Accepted: 04/21/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an inflammatory disease that leads to altered body composition. The loss of lean mass with a preservation or increase in fat mass has been termed rheumatoid cachexia (RC), to contrast with classic cachexia, which is characterized by severe weight loss. There are limited data on the prevalence and progression of cachexia in RA over time, as well as on associated factors. Our aim was to determine the prevalence of cachexia and to determine associations with potential factors. METHODS This prospective cohort study recruited consecutively patients diagnosed with RA and followed for 1 year. The assessments were performed: clinical features, body composition, and physical function. RC and classic cachexia were assessed by several established diagnostic criteria. The pairwise Student's t test, Chi-square test, and GEE were performed (accepted at p ≤ 0.05). RESULTS Of 90 patients recruited, 81 completed the study. Most patients were women (88.9%), and the mean age was 56.5 ± 7.3 years. At baseline, the median DAS28-CRP was 3.0 (IQR, 1.0-3.0), 13.3-30.0% of the included patients had RC, while none met criteria for classic cachexia. The prevalence of cachexia did not change after 12 months. Disease activity status and treatment with biologic disease-modifying antirheumatic drugs were significantly associated with changes on body composition and physical function (p < 0.05). CONCLUSIONS In this cohort, RC was common, while classic cachexia was absent. Disease activity and use of biologic therapies were associated with changes on body composition and physical function, underscoring the importance of aiming for remission when treating RA.
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Affiliation(s)
- Rafaela Ce Santo
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil.
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil.
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil.
| | - Jordana Ms Silva
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | | | - Ana Laura D Moro
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Eduarda C Freitas
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Bárbara J Bartikoski
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Nicole Pb Andrade
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Penélope E Palominos
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Vanessa Hax
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Tayane M Fighera
- Hospital de Clínicas de Porto Alegre, Serviço de Endocrinologia, Porto Alegre, Brazil
| | - Poli Mara Spritzer
- Hospital de Clínicas de Porto Alegre, Serviço de Endocrinologia, Porto Alegre, Brazil
| | - Claiton V Brenol
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | - Rafael Ms Chakr
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
| | | | | | - Ricardo M Xavier
- Hospital de Clínicas de Porto Alegre, Laboratório de Doenças Autoimunes, Porto Alegre, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Porto Alegre, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Reumatologia, Porto Alegre, Brazil
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Hanaoka BY, Ithurburn MP, Rigsbee CA, Bridges SL, Moellering DR, Gower B, Bamman M. Chronic Inflammation in Rheumatoid Arthritis and Mediators of Skeletal Muscle Pathology and Physical Impairment: A Review. Arthritis Care Res (Hoboken) 2019; 71:173-177. [PMID: 30295435 DOI: 10.1002/acr.23775] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022]
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9
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Santo RC, Fernandes KZ, Lora PS, Filippin LI, Xavier RM. Prevalence of rheumatoid cachexia in rheumatoid arthritis: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2018; 9:816-825. [PMID: 30133186 PMCID: PMC6204596 DOI: 10.1002/jcsm.12320] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/18/2018] [Accepted: 05/22/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Low muscle mass occurs in patients with rheumatoid arthritis without weight loss; this condition is referred as rheumatoid cachexia. The aim of the current study was to perform a systematic review with meta-analysis to determine the rheumatoid cachexia prevalence. METHODS A systematic review with meta-analysis of observational studies published in English, between 1994 and 2016, was conducted using MEDLINE (via PubMed) and other relevant sources. Search strategies were based on pre-defined keywords and medical subject headings. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale. Meta-analysis was used to estimate the prevalence, and because studies reported different methods and criteria to estimate body composition and prevalence of rheumatoid cachexia, subgroup analyses were performed. Meta-regression adjusted for the 28-joint disease activity score and disease duration (years) was performed (significance level at P ≤ 0.05). RESULTS Of 136 full articles (one duplicate publication) screened for inclusion in the study, eight were included. The estimated overall prevalence of rheumatoid cachexia was 19% [95% confidence interval (CI) 07-33%]. This prevalence was 29% (95% CI 15-46%) when body composition was measured by dual-energy X-ray absorptiometry. When the diagnostic criteria were fat-free mass index below the 10th percentile and fat mass index above the 25th percentile, rheumatoid cachexia prevalence was 32% (95% CI 14-52%). The 28-joint disease activity score and disease duration had no influence on the estimated prevalence of rheumatoid cachexia (P > 0.05). Most studies were rated as having moderate methodological quality. CONCLUSIONS Meta-analysis showed a prevalence of rheumatoid cachexia of 15-32%, according to different criteria, demonstrating that this condition is a frequent comorbidity of rheumatoid arthritis. To better understand its clinical impact, more studies using standardized definitions and prospective evaluations are urgently needed.
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Affiliation(s)
- Rafaela C.E. Santo
- Hospital de Clínicas de Porto AlegreLaboratório de Doenças AutoimunesPorto AlegreBrazil
- Universidade Federal do Rio Grande do SulFaculdade de MedicinaPorto AlegreBrazil
- Hospital de Clínicas de Porto AlegreServiço de ReumatologiaPorto AlegreBrazil
| | - Kevin Z. Fernandes
- Hospital de Clínicas de Porto AlegreLaboratório de Doenças AutoimunesPorto AlegreBrazil
- Centro Universitário Metodista IPAPorto AlegreBrazil
| | - Priscila S. Lora
- Hospital de Clínicas de Porto AlegreLaboratório de Doenças AutoimunesPorto AlegreBrazil
- Universidade do Vale do Rio dos SinosSão LeopoldoBrazil
| | - Lidiane I. Filippin
- Hospital de Clínicas de Porto AlegreLaboratório de Doenças AutoimunesPorto AlegreBrazil
- Universidade La SalleCanoasBrazil
| | - Ricardo M. Xavier
- Hospital de Clínicas de Porto AlegreLaboratório de Doenças AutoimunesPorto AlegreBrazil
- Universidade Federal do Rio Grande do SulFaculdade de MedicinaPorto AlegreBrazil
- Hospital de Clínicas de Porto AlegreServiço de ReumatologiaPorto AlegreBrazil
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Hallajzadeh J, Safiri S, Mansournia MA, Khoramdad M, Izadi N, Almasi-Hashiani A, Pakzad R, Ayubi E, Sullman MJM, Karamzad N. Metabolic syndrome and its components among rheumatoid arthritis patients: A comprehensive updated systematic review and meta-analysis. PLoS One 2017; 12:e0170361. [PMID: 28333949 PMCID: PMC5363810 DOI: 10.1371/journal.pone.0170361] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/03/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Estimating the current global prevalence of metabolic syndrome (MetS), and its components, among rheumatoid arthritis (RA) patients is necessary in order to formulate preventative strategies and to ensure there are adequate community resources available for these patients. Furthermore, the association between RA and MetS is controversial and has not previously been comprehensively assessed. Therefore, the present study aimed to: 1) determine the prevalence of MetS, and its components, among RA patients across the world 2) update the odds ratio of MetS in RA patients, compared to healthy controls, using a comprehensive systematic review and meta-analysis. METHODS International databases, including: the Web of Science, PubMed, Scopus, Embase, CINAHL and other relevant databases were searched to identify English language articles which reported the prevalence and risk of MetS in RA patients between January 2000 and August 2016. The meta-analysis only included studies which clearly described the time and location of the study, utilised adequate sampling strategies, and appropriate statistical analyses. RESULTS The meta-analyses of prevalence (70 studies [n = 12612]) and risk (43 studies [n = 35220]) of MetS in RA patients were undertaken separately. The overall pooled prevalence of MetS was 30.65% (95% CI: 27.87-33.43), but this varied from 14.32% (95% CI: 10.59-18.05) to 37.83% (95% CI: 31.05-44.61), based upon the diagnostic criteria used. The prevalence of MetS also varied slightly between males (31.94%, 95% CI: 24.37-39.51) and females (33.03%, 95% CI: 28.09-37.97), but this was not statistically significant. The overall pooled odds ratio (OR) of MetS in RA patients, compared to healthy controls, was 1.44 (95% CI: 1.20-1.74), but this ranged from 0.70 (95% CI: 0.27-1.76) to 4.09 (95% CI: 2.03-8.25), depending on the criteria used. The mean age and diagnostic criteria of MetS were identified as sources of heterogeneity in the estimated odds ratios between studies (P<0.05). CONCLUSIONS According to the high prevalence of MetS in RA patients, and high risk of MetS, measuring metabolic syndrome in RA patients is strongly recommended. Furthermore, as high waist circumference (WC) is the most common metabolic syndrome component, more attention must be paid to nutrition and weight loss among those with RA.
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Affiliation(s)
- Jamal Hallajzadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maliheh Khoramdad
- Department of Epidemiology and Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Centre, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Erfan Ayubi
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mark J. M. Sullman
- Driving Research Group, Cranfield University, Bedfordshire, United Kingdom
| | - Nahid Karamzad
- Vice-Chancellery for Food and Drug, Maragheh University of Medical Sciences, Maragheh, Iran
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11
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Hugo M, Pierreisnard A, Mehsen-Cetre N, Gin H, Schaeverbeke T, Rigalleau V. Action of tocilizumab on energy expenditure in rheumatoid arthritis: A prospective study using calorimetry and actimetry. Joint Bone Spine 2016; 84:751-752. [PMID: 28017819 DOI: 10.1016/j.jbspin.2016.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/23/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Marie Hugo
- Nutrition-Diabetology department, CHU Bordeaux, avenue Magellan, 33600 Pessac, France.
| | - Audrey Pierreisnard
- Rheumatology department, CHU Bordeaux, avenue Magellan, 33600 Pessac, France
| | - Nadia Mehsen-Cetre
- Rheumatology department, CHU Bordeaux, avenue Magellan, 33600 Pessac, France
| | - Henri Gin
- Nutrition-Diabetology department, CHU Bordeaux, avenue Magellan, 33600 Pessac, France
| | | | - Vincent Rigalleau
- Nutrition-Diabetology department, CHU Bordeaux, avenue Magellan, 33600 Pessac, France
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12
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Dessein PH, Solomon A, Hollan I. Metabolic abnormalities in patients with inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol 2016; 30:901-915. [DOI: 10.1016/j.berh.2016.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 12/20/2022]
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