Characteristics of sarcopenia in patients with rheumatoid arthritis at a central university hospital in Hanoi, Vietnam: a cross-sectional study.

Abstract

Aim: To determine the prevalence and factors associated with sarcopenia in rheumatoid arthritis (RA) patients at a central university hospital in Hanoi, Vietnam.

Methods: Patients with RA aged ≥ 18 were enrolled in this cross-sectional study. Dual-energy X-ray absorptiometry was performed to measure appendicular skeletal muscle (ASM). Assessment of muscle function included hand grip strength (HGS) and gait speed (GS). Sarcopenia was defined according to Asian Working Group for Sarcopenia (AWGS) criteria 2019. RA disease activity was evaluated by disease activity score 28 CRP (DAS28-CRP). Medical history and previous medications including steroids, methotrexate, bDMARDs, clinical characteristics, and comorbidities were also documented. Multivariable adjusted regression was used to examine potential factors associated with sarcopenia in patients with RA.

Results: A total of 156 patients with RA were recruited, out of which the prevalence of sarcopenia was 62.82%. Among the participants, 95.16% had a low appendicular lean mass index (ALMI), 91.67% had low hand grip strength, and 36.54% had slow gait speed. Active RA disease was significantly associated with a higher odd ratio of having sarcopenia, low muscle mass, and low hand grip strength. After adjusting for potential factors, male (aOR 6.66), RA disease activity level (aOR 3.07), and hypertension (aOR 4.06) were statistically independent factors associated with sarcopenia.

Conclusion: Effective RA management to achieve clinical remission is essential to mitigate sarcopenia risk. Further studies are essential to better understand sarcopenia and improve management in patients with RA. Key Points • Prevalence: Sarcopenia was present in 62.82% of patients with RA, especially in those with higher disease activity. • Risk Factors: Male gender, active disease, and hypertension were associated with sarcopenia. • Inflammation and disease activity: Active RA and elevated CRP levels were linked to reduced muscle mass and strength.