Фенотипы состава тела, физическая работоспособность и качество жизни у женщин с ревматоидным артритом

Добровольская О.В., Торопцова Н.В., Феклистов А.Ю., Демин Н.В., Сорокина А.О., Никитинская О.А. Фенотипы состава тела, физическая работоспособность и качество жизни у женщин с ревматоидным артритом. Терапевтический архив. 2022;94(5):654–660. DOI: 10.26442/00403660.2022.05.201494

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Dobrovolskaya OV, Toroptsova NV, Feklistov AYu, Demin NV, Sorokina AO, Nikitinskaya OA. Phenotypes of body composition, physical performance and quality of life in women with rheumatoid arthritis. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(5):654–660. DOI: 10.26442/00403660.2022.05.201494

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Аннотация

Цель. Оценить частоту различных фенотипов состава тела, физическую работоспособность (ФРС) и их связь с качеством жизни (КЖ) у женщин с ревматоидным артритом (РА).
Материалы и методы. В исследование включены 157 женщин (средний возраст 58,6±8,8 года) с диагнозом РА. Проведены клинико-лабораторное обследование, двуэнергетическая рентгеновская абсорбциометрия, оценка КЖ по опросникам EQ-5D (European Quality of Life Questionnaire), HADS (Hospital Anxiety and Depression Scale) и RAID (Rheumatoid Arthritis Impact of Disease), определение силы мышц и ФРС скелетных мышц.
Результаты. Остеопоротический, саркопенический и остеосаркопенический фенотипы состава тела выявлены у 27 (17%), 16 (10%) и 16 (10%) пациенток соответственно; 139 (88,5%) человек имели низкую мышечную силу, а 96 (61,1%) – сниженную ФРС. КЖ по индексу EQ-5D и RAID, выраженность депрессии по HADS у женщин с различными фенотипами состава тела не различались. Женщины с остеосаркопеническим фенотипом имели худшие показатели по EQ-5D-ВАШ (ВАШ – визуальная аналоговая шкала), а с саркопеническим фенотипом – более выраженную тревогу по анкете HADS по сравнению с лицами с нормальным фенотипом (р=0,014 и р=0,027 соответственно). КЖ по всем опросникам было значимо хуже у пациенток со сниженной ФРС.
Заключение. Патологические фенотипы состава тела обнаружены у 37% больных РА. Уменьшение мышечной силы выявлено у 88,5%, а низкая ФРС – у 61,1% пациенток. Не установлено взаимосвязи между КЖ и составом тела, в то же время КЖ зависело от ФРС скелетных мышц.

Ключевые слова: ревматоидный артрит, состав тела, остеопороз, саркопения, качество жизни, физическая работоспособность, сила мышц

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Aim. To evaluate the frequency of different body composition phenotypes, physical performance (PP) and their relationship with quality of life in women with rheumatoid arthritis (RA).
Materials and methods. The study included 157 women (average age 58.6±8.8 years) with RA. Clinical and laboratory examination, dual-energy X-ray absorptiometry, quality of life assessment according to the questionnaires EQ-5D (European Quality of Life Questionnaire), HADS (Hospital Anxiety and Depression Scale) and RAID (Rheumatoid Arthritis Impact of Disease), determination of muscle strength and the PP of skeletal muscles were carried out.
Results. Osteoporotic, sarcopenic and osteosarcopenic phenotypes of body composition were identified in 27 (17%), 16 (10%) and 16 (10%) patients, respectively; 139 (88.5%) people had low muscle strength, and 96 (61.1%) had reduced PP. Quality of life according to the EQ-5D index and RAID, the severity of depression according to HADS in women with different phenotypes of body composition did not differ. Women with osteosarcopenic phenotype had worse indicators for EQ-5D-VAS (VAS – visual analog scale), and patients with sarcopenic phenotype had more severe anxiety according to the HADS questionnaire compared to those with normal phenotype (p=0.014 and p=0.027, respectively). The quality of life according to all questionnaires was significantly worse in patients with reduced PP.
Conclusion. Pathological phenotypes of body composition were found in 37% of RA patients. A decrease in muscle strength was revealed in 88.5%, and a low PP – in 61.1% of patients. The relationship between quality of life and body composition has not been established, at the same time quality of life associated with the PP of skeletal muscles.

Keywords: rheumatoid arthritis, body composition, osteoporosis, sarcopenia, quality of life, physical performance, muscle strength

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Список литературы

1. Demontiero O, Boersma D, Suriyaarachchi P, Duque G. Clinical outcomes of impaired muscle and bone interactions. Clin Rev Bone Miner Metab. 2014;12:86-92.
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[Toroptsova NV, Dobrovolskaya OV, Efremova AO, Nikitinskaya OA. Diagnostic value of the SARC-F questionnaire and muscle strength tests for the detection of sarcopenia in patients with rheumatoid arthritis. Rheumatology Science and Practice. 2020;58(6):678-82 (in Russian)]. DOI:10.47360/1995-4484-2020-678-682
5. Ekblom B, Lövgren O, Alderin M, et al. Physical Performance in Patients with Rheumatoid Arthritis. Scand J Rheumatol. 1974;3(3):121-5. DOI:10.3109/03009747409097136
6. Stavropoulos-Kalinoglou A, Metsios G, Koutedakis Y, et al. Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis. 2007;66(10):1316-21. DOI:10.1136/ard.2006.060319
7. Salaffi F, Carotti M, Gasparini S, et al. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes. 2009;7:25. DOI:10.1186/1477-7525-7-25
8. Garip Y, Eser F, Bodur H. Health-related quality of life in rheumatoid arthritis: comparison of RAQoL with other scales in terms of disease activity, severity of pain, and functional status. Rheumatol Int. 2011;31(6):769-72. DOI:10.1007/s00296-009-1353-1
9. Haugeberg G, Orstavik RE, Uhlig T, et al. Clinical decision rules in rheumatoid arthritis: do they identify patients at high risk for osteoporosis? Testing clinical criteria in a population based cohort of patients with rheumatoid arthritis recruited from the Oslo Rheumatoid Arthritis Register. Ann Rheum Dis. 2002;61(12):1085-9. DOI:10.1136/ard.61.12.1085
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15. Vlietstra L, Stebbings S, Meredith-Jones K, et al. Sarcopenia in osteoarthritis and rheumatoid arthritis: The association with self-reported fatigue, physical function and obesity. PLoS ONE. 2019;14(6):e0217462. DOI:10.1371/journal.pone.0217462
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20. Ji J, Zhang L, Zhang Q, et al. Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis. Health Qual Life Outcomes. 2017;15(1):89. DOI:10.1186/s12955-017-0659-z
21. Kang SY, Lim J, Park HS. Relationship between low handgrip strength and quality of life in Korean men and women. Qual Life Res. 2018;27(10):2571-80.
DOI:10.1007/s11136-018-1920-6
22. Sun S, Lee H, Yim HW, et al. The impact of sarcopenia on health-related quality of life in elderly people: Korean National Health and Nutrition Examination Survey. Korean J Intern Med. 2019;34(4):877-84. DOI:10.3904/kjim.2017.182
23. Сафонова Ю.А., Зоткин Е.Г., Торопцова Н.В. Качество жизни и синдром усталости у пожилых пациентов с саркопенией. Современная ревматология. 2021;15(6):41-7 [Safonova YuA, Zotkin EG, Toroptsova NV. Quality of life and fatigue in elderly patients with sarcopenia. Modern Rheumatology Journal. 2021;15(6):41-7 (in Russian)]. DOI:10.14412/1996-7012-2021-6-41-47

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1. Demontiero O, Boersma D, Suriyaarachchi P, Duque G. Clinical outcomes of impaired muscle and bone interactions. Clin Rev Bone Miner Metab. 2014;12:86-92.
DOI:10.1007/s12018-014-9164-7
2. Cruz-Jentoft AJ, Bahat G, Bauer JM, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. DOI:10.1093/ageing/afy169
3. Beenakker K, Ling C, Meskers C, et al. Patterns of muscle strength loss with age in the general population and patients with a chronic inflammatory state. Ageing Res Rev. 2010;9(4):431-6. DOI:10.1016/j.arr.2010.05.005
4. Toroptsova NV, Dobrovolskaya OV, Efremova AO, Nikitinskaya OA. Diagnostic value of the SARC-F questionnaire and muscle strength tests for the detection of sarcopenia in patients with rheumatoid arthritis. Rheumatology Science and Practice. 2020;58(6):678-82 (in Russian). DOI:10.47360/1995-4484-2020-678-682
5. Ekblom B, Lövgren O, Alderin M, et al. Physical Performance in Patients with Rheumatoid Arthritis. Scand J Rheumatol. 1974;3(3):121-5. DOI:10.3109/03009747409097136
6. Stavropoulos-Kalinoglou A, Metsios G, Koutedakis Y, et al. Redefining overweight and obesity in rheumatoid arthritis patients. Ann Rheum Dis. 2007;66(10):1316-21. DOI:10.1136/ard.2006.060319
7. Salaffi F, Carotti M, Gasparini S, et al. The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes. 2009;7:25. DOI:10.1186/1477-7525-7-25
8. Garip Y, Eser F, Bodur H. Health-related quality of life in rheumatoid arthritis: comparison of RAQoL with other scales in terms of disease activity, severity of pain, and functional status. Rheumatol Int. 2011;31(6):769-72. DOI:10.1007/s00296-009-1353-1
9. Haugeberg G, Orstavik RE, Uhlig T, et al. Clinical decision rules in rheumatoid arthritis: do they identify patients at high risk for osteoporosis? Testing clinical criteria in a population based cohort of patients with rheumatoid arthritis recruited from the Oslo Rheumatoid Arthritis Register. Ann Rheum Dis. 2002;61(12):1085-9. DOI:10.1136/ard.61.12.1085
10. Sarkis KS, Salvador MB, Pinheiro MM, et al. Association between osteoporosis and rheumatoid arthritis in women: a cross-sectional study. Sao Paulo Med J. 2009;127(4):216-22. DOI:10.1590/s1516-31802009000400007
11. Forsblad d'Elia H, Larsen A, Waltbrand E, et al. Radiographic joint destruction in postmenopausal rheumatoid arthritis is strongly associated with generalized osteoporosis. Ann Rheum Dis. 2003;62(7):617-23. DOI:10.1136/ard.62.7.617
12. Lee JH, Sung YK, Choi CB, et al. The frequency of and risk factors for osteoporosis in Korean patients with rheumatoid arthritis. BMC Musculoskelet Disord. 2016;17:98. DOI:10.1186/s12891-016-0952-8
13. Mochizuki T, Yano K, Ikari K, Okazaki K. Sarcopenia-associated factors in Japanese patients with rheumatoid arthritis: A cross-sectional study. Geriatr Gerontol Int. 2019;19(9):907-12. DOI:10.1111/ggi.13747
14. Minamino H, Katsushima M, Torii M, et al. Serum vitamin D status inversely associates with a prevalence of severe sarcopenia among female patients with rheumatoid arthritis. Sci Rep. 2021;11(1):20485. DOI:10.1038/s41598-021-99894-6
15. Vlietstra L, Stebbings S, Meredith-Jones K, et al. Sarcopenia in osteoarthritis and rheumatoid arthritis: The association with self-reported fatigue, physical function and obesity. PLoS ONE. 2019;14(6):e0217462. DOI:10.1371/journal.pone.0217462
16. Barone M, Viggiani MT, Anelli MG, et al. Sarcopenia in Patients with Rheumatic Diseases: Prevalence and Associated Risk Factors. J Clin Med. 2018;7(12):504. DOI:10.3390/jcm7120504
17. Wiegmann S, Armbrecht G, Borucki D, et al. Association between sarcopenia, physical performance and falls in patients with rheumatoid arthritis: a 1-year prospective study. BMC Musculoskelet Disord. 2021;22(1):885. DOI:10.1186/s12891-021-04605-x
18. Tekgoz E, Colak S, Ozalp Ates FS, et al. Sarcopenia in rheumatoid arthritis: Is it a common manifestation? Int J Rheum Dis. 2020;23(12):1685-91. DOI:10.1111/1756-185X.13976
19. Katchamart W, Narongroeknawin P, Chanapai W, Thaweeratthakul P. Health-related quality of life in patients with rheumatoid arthritis. BMC Rheumatol. 2019;3:34. DOI:10.1186/s41927-019-0080-9
20. Ji J, Zhang L, Zhang Q, et al. Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis. Health Qual Life Outcomes. 2017;15(1):89. DOI:10.1186/s12955-017-0659-z
21. Kang SY, Lim J, Park HS. Relationship between low handgrip strength and quality of life in Korean men and women. Qual Life Res. 2018;27(10):2571-80.
DOI:10.1007/s11136-018-1920-6
22. Sun S, Lee H, Yim HW, et al. The impact of sarcopenia on health-related quality of life in elderly people: Korean National Health and Nutrition Examination Survey. Korean J Intern Med. 2019;34(4):877-84. DOI:10.3904/kjim.2017.182
23. Safonova YuA, Zotkin EG, Toroptsova NV. Quality of life and fatigue in elderly patients with sarcopenia. Modern Rheumatology Journal. 2021;15(6):41-7 (in Russian). DOI:10.14412/1996-7012-2021-6-41-47

Авторы

О.В. Добровольская*, Н.В. Торопцова, А.Ю. Феклистов, Н.В. Демин, А.О. Сорокина, О.А. Никитинская

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия
*olgavdobr@mail.ru

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Olga V. Dobrovolskaya*, Natalia V. Toroptsova, Alexey Yu. Feklistov, Nikolay V. Demin, Arina O. Sorokina, Oksana A. Nikitinskaya

Nasonova Research Institute of Rheumatology, Moscow, Russia
*olgavdobr@mail.ru

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