Rheumatoid arthritis is associated with exacerbated body composition deterioration in Kazakh females.

OBJECTIVE: The aim of this study was to assess the magnitude of changes in nutritional body composition components as a consequence of rheumatoid arthritis (RA) and the extent to which these components are associated with RA clinical characteristics, serologic markers, and osteoporosis-related phenotypes (OP-RPs). Early pathologic signs, if detected, could assist in future preventative techniques. METHODS: The study sample was comprised of 260 women with RA and 168 first-degree female relatives without RA who returned for body composition measurements using bioelectrical impedance analysis, from a previously established epidemiologic study conducted in Kazakhstan. RESULTS: In multivariate logistic regression, body composition components, the fat mass index (odds ratio [OR], 0.848; 95% confidence interval [CI], 0.786-0.913; P < 0.001) and the phase angle (PA; OR, 0.654; 95% CI, 0.467-0.826; P = 0.001), were independently and significantly negatively associated with RA after disease development. In multilinear regression analysis, PA was consistently associated with OP-RP, specifically concerning the spongial bone mineral density (BMDSPN) and cortical index, where ageing, reduced PA and increased disease duration explained 31.5% of BMDSPN and 37.3% of cortical index variation. CONCLUSION: Data on RA in women in Kazakhstan consistently show that fat mass index and PA act as independent major covariates associated with RA affection status. These findings suggest exacerbated body composition deterioration when compared with healthy controls, potentially indicating the early appearance of sarcopenia and likely cachexic-like properties. The data also suggest that PA could serve as a potential predictor of RA prognosis, and the concomitant development of osteoporosis.

An epidemiological analysis of osteoporotic characteristics in patients affected with rheumatoid arthritis in Kazakhstan.

PURPOSE: We aimed to assess which of the major risk factors associated with rheumatoid arthritis (RA) severity are also associated with osteoporosis-related phenotypes (OP-RP) in the native population of Kazakhstan. METHODS: Four hundred six RA patients (90.6% females) with 397 controls-unaffected first-degree relatives were recruited. Biochemical factors were recorded, and OP-RP were assessed using QCT scans and ultrasound densitometry (US) of the forearm to estimate cortical indices (CI), spongial bone mineral density (BMDSPN), and US_T-scores. RESULTS: In the RA affected female population, ~ 80% suffered from osteopenia or osteoporosis. All OP-RP were negatively correlated with age and female's sex, as expected, and thus accordingly adjusted, resulting in consistent, significantly [p = 0.016 (CI), p < 0.0001 (both BMDSPN and US_T-scores)] lower OP-RP estimates in affected females. Using multiple regression analysis for OP-RP manifestations, only age and disease duration appeared consistently associated with all three studied phenotypes, while menopause status or years following the onset of menopause were also significant for BMDSPN and US_T-scores. However, when disease duration was examined, we found that it was significantly dependent on morning stiffness, ESR, total cholesterol levels, weight, and menopause status, which explains 38.6% of the disease duration. CONCLUSIONS: Approximately 80% of female RA patients suffer from osteoporosis or osteopenia in the study group, which appears from a young age. RA disease duration is the major risk factor for OP-RP deterioration, especially as assessed by BMDSPNG, and US_T-scores. As a result, all OP-RP demonstrate significantly lower levels in comparison to sex- and age-matched unaffected individuals.