Obesity is more strongly associated with physical performance and body composition than sarcopenia in patients with spondyloarthritis

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2026-09-26 DOI:10.1093/rheumatology/keag530

Uta Kiltz,Julia Kononenko,Marius Bedei,Imke Redeker,David Kiefer,Philipp Sewerin,Ioana Andreica,Anna Kernder,Diana Vossen,Bjoern Bühring,Ralph Brinks,Xenofon Baraliakos

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引用次数: 0

Abstract

Abstract Objectives Integrated data on body composition, objective physical performance and daily physical activity are limited in spondyloarthritis (SpA). The objective of this study is to describe DXA-derived body composition phenotypes and examine their cross-sectional associations with objective physical performance and daily physical activity in axial SpA (axSpA) and psoriatic arthritis (PsA). Methods In this single-center cross-sectional study, 213 patients with axSpA or PsA underwent performance testing and completed the mSQUASH questionnaire. Obesity was defined using DXA-derived body fat percentage (≥30% in men, ≥40% in women). Physical activity was categorized into tertiles. ANCOVA models adjusted for age, BMI and diagnosis assessed independent effects of physical activity on performance and body composition. Results Physical performance was largely preserved. DXA-defined obesity was common whereas sarcopenia was rare. Higher levels of daily activity were consistently associated with better physical performance and favorable body composition. Patients in the highest mSQUASH activity tertile demonstrated significantly higher grip strength (45.3 (13.0) kg), faster gait speed (1.60 (0.27) m/s), and higher SPPB scores (11.5 (1.0), alongside lower FMI and higher ALM/BMI. In sex-stratified analyses, TNFi-treated men had lower body fat and obesity prevalence than men on conventional therapy; no differences were observed in women. In adjusted models, daily physical activity remained independently associated with ALM/BMI, grip strength and ASPI, whereas diagnosis showed no independent association. Conclusion In SpA, DXA-defined obesity was common and associated with worse objective performance, whereas sarcopenia was rare. Higher levels of daily physical activity were independently associated with better physical performance and more favourable muscle-related body composition indices.

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与骨骼肌减少症相比，肥胖与脊椎关节炎患者的身体表现和身体组成的关系更为密切

摘要目的脊柱关节炎（SpA）患者的身体组成、客观体能表现和日常体力活动的综合数据有限。本研究的目的是描述dxa衍生的身体成分表型，并检查其与轴向SpA （axSpA）和银屑病关节炎（PsA）的客观身体表现和日常身体活动的横断面关联。方法在这项单中心横断面研究中，213例axSpA或PsA患者接受了性能测试，并完成了mSQUASH问卷。肥胖的定义是使用dxa衍生体脂百分比（男性≥30%，女性≥40%）。体育活动被分为三类。调整了年龄、BMI和诊断的ANCOVA模型评估了体力活动对表现和身体成分的独立影响。结果大鼠身体机能基本保持。dxa定义的肥胖很常见，而肌肉减少症很少见。高水平的日常活动始终与更好的身体表现和良好的身体组成有关。mSQUASH活动量最高的患者表现出更高的握力（45.3 (13.0)kg），更快的步速（1.60 (0.27)m/s），更高的SPPB评分（11.5(1.0)），以及更低的FMI和更高的ALM/BMI。在性别分层分析中，接受tnfi治疗的男性体脂和肥胖患病率低于接受常规治疗的男性；在女性中没有观察到差异。在调整后的模型中，日常体力活动仍然与ALM/BMI、握力和ASPI独立相关，而诊断显示没有独立关联。结论：在SpA中，dxa定义的肥胖是常见的，并且与较差的客观表现相关，而肌肉减少症是罕见的。较高的日常体力活动水平与更好的身体表现和更有利的肌肉相关身体成分指数独立相关。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.