类风湿关节炎并发肌少症的危险因素分析

Risk factor analysis of sarcopenia in rheumatoid arthritis

目的分析类风湿关节炎(rheumatoid arthritis,RA)并发肌少症的危险因素。方法收集我院门诊RA患者123例的临床资料、骨密度、体成分、血清肌生成抑制素,将临床资料完整的100例患者分为肌少症组(20例)和无肌少症组(80例)。比较两组的临床特征及肌抑素水平,采用二元逻辑回归分析可能与RA并发肌少症相关的因素。结果RA患者中肌少症发生率17.89%。与无肌少症组相比,肌少症组RA病程较长(P=0.028),关节肿痛数、ESR、CRP、IL-6、DAS28及HAQ评分、低骨量/骨质疏松发生率、激素使用率显著增高(P=0.000~0.009)。两组脂肪含量指数(FMI)比较,差异无统计学意义(P>0.05)。两组血清肌抑素水平比较,差异无统计学意义(P>0.05)。结论RA病程长且疾病控制不佳易并发肌少症,IL-6是RA相关肌少症的独立危险因素。

Ohjective To analyze the risk factors of sarcopenia in patients with rheumatoid arthritis(RA).Methods The clinical data,bone mineral density,body composition and serum myostatin of RA patients in the Second Affiliated Hospital of Fwjian Medical University from June 2019 to Decermber 2020 were collected and divided into sarcopenia group and non-sarcope-nia group.The clinical characteristics and myostatin levels of the two groups were compared.Binary logistic regression analysis was used to analyze the factors that might be associated with RA complicated with sarcopenia.Results The prevalence of sar-copenia in RA was 17.89%.Compared with the RA with non-sarcopenia group,the duration of RA was longer(P=0.028),swollen joint count,tender joint count,ESR,CRP,IL-6,DAS28 and HAQ scores,the incidence rate of osteoporosis/osteope-nia,and the hormone usage rate were significantly higher in the RA with sarcopenia group(P=0.000-0.009).There was no significant difference in fat mass index(FMI)between the two groups(P=0.092).There was no significant difference in serum myostatin level between the two groups(P>0.05).Conclusion The long course of RA and poor disease control may lead to sarcopenia.IL-6 is an independent risk factor for RA-associated sarcopenia.