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Original Article
Available online 9 December 2021
Relationship between polyautoimmunity and sarcopenic obesity in rheumatoid arthritis patients
Relación entre poliautoinmunidad y obesidad sarcopénica en pacientes con artritis reumatoide
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Natalia Mena-Vázqueza,b,
, Sara Manrique-Arijaa,b,**, María Carmen Ordoñez-Cañizaresa,b, Rocio Redondo-Rodrigueza,b, José Rioja Villodresa,c, Laura Cano-Garciaa,b, Francisco Javier Godoy-Navarretea,b, Francisco Gabriel Jiménez Nuñeza,b, Gisela Diaz-Cordovés Regoa,b, Inmaculada Ureña Garnicaa,b, Antonio Fernández-Nebroa,b,c
a Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
b UGC de Reumatología, Hospital Regional Universitario de Málaga, Málaga, Spain
c Departamento de Medicina y Dermatología, Centro de Investigaciones Médico-Sanitarias (CIMES), Universidad de Málaga, Málaga, Spain
Received 28 March 2021. Accepted 17 June 2021
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Tables (4)
Table 1. Characteristics of RA patients without polyautoimmunity (n = 79), patients with RA and polyautoimmunity (n = 15).
Table 2. Anthropometric and metabolic characteristics of patients with RA and polyautoimmunity.
Table 3. Inflammatory cytokine and adipokine profile of patients with RA and polyautoimmunity.
Table 4. Logistic regression model 1 of characteristics associated with polyautoimmunity in patients with RA.
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Abstract
Objective

Sarcopenia is a major cause of morbidity in rheumatoid arthritis patients. Our purpose was to determine whether polyautoimmunity is associated with sarcopenia and alterations in whole body composition in patients with rheumatoid arthritis (RA).

Methods

We performed a cross-sectional observational study of a series of cases of RA. All patients were recruited consecutively from a rheumatology clinic. Body composition by dual-energy x-ray absorptiometry (DEXA) was assessed. The variables of interest were polyautoimmunity (RA associated with other autoimmune diseases), sarcopenia, fat mass, and body mass index (BMI). Other variables included were clinical-analytical and inflammatory cytokines and adipokines. The relationship between sarcopenic obesity and the presence of polyautoimmunity was studied using multivariate analysis.

Results

Of the 94 patients with RA included in the study, 15 (16%) had polyautoimmunity. A total of 23 patients with RA (24.5%) had sarcopenia, which was more prevalent in patients with polyautoimmunity than in patients without polyautoimmunity (46.7% vs 20.3%; p = .029). Sarcopenia was not associated with body fat content (p = .870) or with BMI (p = .998). The multivariate analysis showed the factors associated with polyautoimmunity in RA to be sarcopenia (odds ratio [95% CI], 4.80 [1.49-13.95]), BMI (1.18 [1.04-1.35]), and resistin (1.249 [1.01-1.53]).

Conclusion

Sarcopenia and obesity were more prevalent in patients with RA and polyautoimmunity. Resistin values were also higher in this group than in patients with RA without polyautoimmunity.

Keywords:
Rheumatoid arthritis
Polyautoimmunity
Sarcopenic
Obesity
Resumen
Objetivo

Analizar si la poliautoinmunidad en los pacientes con artritis reumatoide (AR) se asocia con sarcopenia y alteraciones de la composición corporal total.

Métodos

Estudio observacional transversal de una serie de casos de pacientes con AR, reclutados consecutivamente de la consulta de reumatología. Se evaluó la composición corporal mediante absorciometria de rayos X de energia dual (DXA). Las variables de interés fueron la poliautoinmunidad (AR asociada a otras enfermedades autoinmunes), sarcopenia, masa grasa e índice de masa corporal. Otras variables incluidas fueron clínico-analíticas y citoquinas inflamatorias y adipoquinas. La relación entre obesidad sarcopénica y la presencia de poliautoinmunidad se estudió mediante análisis multivariable.

Resultados

De los 94 pacientes con AR incluidos en el estudio, 15 (16%) tenían poliautoinmunidad. Un total de 23 (24,5%) pacientes con AR presentaron sarcopenia, la cual fue más prevalente en los pacientes con poliautoinmunidad en comparación con los demás (46,7 vs. 20,3%; p = 0,029). La sarcopenia no se asoció con el contenido corporal de grasa en la composición corporal (p = 0,870) ni con el índice de masa corporal (IMC) (p = 0,998). En el análisis multivariante, los factores asociados a la poliautoinmunidad en AR fueron la sarcopenia (odds ratio [IC 95%], 4,80 [1,49-13,95]), el IMC (1,18 [1,04-1,35]), y la resistina (1,249 [1,01-1,53]).

Conclusión

Los pacientes con AR con poliautoinmunidad mostraron una mayor prevalencia de sarcopenia y obesidad, además tuvieron valores más elevados de resistina en comparación con pacientes con AR sin poliautoinmunidad.

Palabras clave:
Artritis reumatoide
Poliautoinmunidad
Sarcopenia
Obesidad

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