BMC Rheumatology最新文献

{"title":"Unraveling cerebrovascular involvement in EGPA through digital subtraction angiography: case presentation and systematic literature review.","authors":"Viren Vasandani, Sean O'Leary, Ronak Gandhi, Elena Diller, Giri Movva, John Broussard, Vijaya Murthy","doi":"10.1186/s41927-025-00518-7","DOIUrl":"10.1186/s41927-025-00518-7","url":null,"abstract":"<p><strong>Objectives: </strong>Eosinophilic granulomatosis with polyangiitis (EGPA) involves systemic inflammation of small to medium vessels, with central nervous system (CNS) involvement being rare. While CT (computed tomography) and MRI (magnetic resonance imaging) are standard for diagnosing CNS involvement, digital subtraction angiography (DSA) is infrequently used. We present a unique EGPA case with CNS involvement and review EGPA CNS vascular variations.</p><p><strong>Methods: </strong>We present a case of EGPA with CNS involvement, alongside a systematic review of the literature following PRISMA guidelines, querying three databases (PubMed/MEDLINE, SCOPUS, and Science Direct) up to September 2023 for case reports and series on EGPA with CNS involvement.</p><p><strong>Results: </strong>A 43-year-old presented with wheezing, multifocal neuropathy, leukocytosis, eosinophilia, positive ANA, and elevated CRP. Imaging revealed lung abnormalities. CT and MRI showed cerebral infarcts. CTA was negative, whereas DSA revealed bilateral segmental narrowing of anterior cerebral artery (ACA) branches and middle cerebral artery (MCA) branches. EGPA was confirmed, and treatment with steroids, cyclophosphamide, and azathioprine, led to remission. A systematic literature review of 27 EGPA cases with CNS involvement found a mean age 54.22 years, with common symptoms including extremity weakness (n = 8) and paresthesia (n = 5). Imaging techniques included MRI (n = 21), CT (n = 11), angiogram (n = 8), MRA (n = 4), CTA (n = 4), and MRV (n = 2), revealing stenosis of the bilateral ACA, vertebral artery, MCA, and basilar artery.</p><p><strong>Conclusion: </strong>Our findings suggest a potentially novel role for angiographic imaging in the comprehensive assessment of cerebrovascular involvement in EGPA.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"80"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between life's essential 8 and risk of rheumatoid arthritis: a cross-sectional study.","authors":"Longyun Wu, Jing Wang, Xueji Wang, Xuefeng Yue","doi":"10.1186/s41927-025-00536-5","DOIUrl":"10.1186/s41927-025-00536-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between Life's Essential 8 (LE8) and its individual constituents and the risk of rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>This cross-sectional study included participants aged 20 years and older from the NHANES database from 2005 to 2018. LE8 scores and scores for each of the LE8 components including diet, physical activity, nicotine exposure, sleep health, body mass index, lipids, blood glucose and blood pressure, were classified as cardiovascular health (CVH) scores of low (0-49), moderate (50-74), and high (75-100). Multivariate logistic regression was used to assess the association between LE8 scores and individual LE8 metric scores and the risk of RA. A curve-fitting model was used to assess the dose-response relationship between LE8 scores and RA risk.</p><p><strong>Results: </strong>Of the 17,943 subjects (mean age: 46.10 ± 16.99 years; 48.33% males) included, 1233 were identified as having RA. After multivariate adjustment, participants with an intermediate or high LE8 score were associated with a reduced risk of RA compared to those with a low LE8 score (intermediate LE8 score: OR = 0.66, 95% CI = 0.62-0.71; high LE8 score: OR = 0.66, 95% CI = 0.62-0.71). Similar risk patterns were found for diet, nicotine exposure, sleep health, body mass index, and blood glucose. The dose-response relationship between LE8 score and RA risk was nonlinear.</p><p><strong>Conclusions: </strong>Higher scores of CVH, assessed by Life's Essential 8, were significantly associated with a lower risk of RA. Maintaining an ideal CVH score in the general population may be beneficial in preventing RA.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"72"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-induced hypersensitivity reaction presenting as systemic capillary leak-like syndrome with polyserositis: a case report.","authors":"Ninh Xuan Nguyen, Ngoc Tien Pham, Huong Thi Thanh Le, Quoc Viet Tran, Hang Ngoc Thuy Tran, An Thien Do","doi":"10.1186/s41927-025-00535-6","DOIUrl":"10.1186/s41927-025-00535-6","url":null,"abstract":"<p><strong>Background: </strong>Systemic capillary leak syndrome (SCLS) is a rare disorder characterized by increased vascular permeability leading to third-spacing of fluids and protein. Drug-induced hypersensitivity reactions can mimic SCLS clinically and radiologically.</p><p><strong>Case presentation: </strong>A 42-year-old Vietnamese man developed abdominal distension, facial edema, and dyspnea after initiation of Helicobacter pylori eradication therapy. Imaging revealed pleural, pericardial, and peritoneal effusions, periportal edema, and interstitial pulmonary edema. Laboratory results showed hyponatremia, hypoalbuminemia, and mild anemia. Autoimmune screening revealed ANA positivity (1:80, speckled) and lupus anticoagulant, though extractable nuclear antigens were negative. The patient improved rapidly with corticosteroids and antihistamines.</p><p><strong>Conclusion: </strong>This case suggests a probable drug-induced systemic hypersensitivity reaction mimicking capillary leak syndrome, occurring in a patient with latent immune dysregulation. Awareness of this presentation may facilitate early recognition and appropriate immunomodulatory treatment while avoiding unnecessary interventions.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"74"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of clinical and serological biomarkers in a nomogram for predicting interstitial lung disease in idiopathic inflammatory myopathies.","authors":"Zhixia Wang, Jingyun Zhang, Jin Li, Xiaona Mao, Yangyang Li, Dekun Wang, Wenpeng Ge, Jingzhan Li, Changhua Liang, Zhiqiang Zhang","doi":"10.1186/s41927-025-00534-7","DOIUrl":"10.1186/s41927-025-00534-7","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic inflammatory myopathies (IIM) are a diverse group of autoimmune diseases characterized primarily by muscle weakness and systemic involvement, which can include interstitial lung disease (ILD). ILD is a serious complication in IIM, significantly affecting patient prognosis and quality of life. Early identification of IIM patients at risk for developing ILD is crucial for timely intervention and personalized treatment, yet the factors contributing to this risk remain inadequately defined.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records of 130 patients with IIM from the First Affiliated Hospital of Xinxiang Medical University, China, between August 2018 and July 2023. Patients were categorized into two groups: IIM with interstitial lung disease (IIM-ILD, n = 75) and IIM without ILD (n = 55). We collected and analyzed demographic, clinical, and laboratory data, including specific autoantibody tests. Multivariate logistic regression identified independent predictors of ILD, and a nomogram was developed to evaluate ILD risk based on significant factors.</p><p><strong>Results: </strong>This retrospective study analyzed 130 patients with IIM, including 75 with interstitial lung disease and 55 without ILD. The IIM-ILD group was significantly older (58.4 vs. 48.3, p = 0.052) and had higher frequencies of respiratory symptoms including dyspnea (61.3% vs. 14.9%, p < 0.001) and cough (54.7% vs. 10.9%, p < 0.001). Key laboratory differences included elevated ESR (26.5 vs. 10.0 mm/H, p < 0.001), CRP (3.44 vs. 1.64 mmol/L, p = 0.013), and IgG (12.5 vs. 10.9 g/L, p = 0.006), along with lower ALT (29.0 vs. 44.0 U/L, p = 0.001) and AST (32.0 vs. 45.0 U/L, p = 0.021) in the IIM-ILD group. Anti-Jo-1 antibodies were more prevalent in IIM-ILD patients (18.7% vs. 5.5%, p = 0.027). Multivariate analysis identified ESR (OR = 1.063, 95% CI:1.012-1.117, p = 0.015), AST (OR = 0.985, 95% CI:0.970-1.000, p = 0.047), and IgG (OR = 1.191, 95% CI:1.025-1.383, p = 0.022) as independent predictors. These factors, combined with dyspnea and anti-Jo-1 status, were incorporated into a predictive nomogram model. The nomogram demonstrated excellent discrimination (AUC = 0.891, 95% CI:0.836-0.947) with sensitivity of 79.7% and specificity of 82.6%. Calibration curves showed good agreement between predicted and observed outcomes (Hosmer-Lemeshow test, p = 0.779). Decision curve analysis confirmed the model's clinical utility across a wide range of threshold probabilities. This comprehensive model provides clinicians with a practical tool for early identification of IIM patients at high risk for ILD development.</p><p><strong>Conclusion: </strong>Elevated ESR and CRP levels, in conjunction with lower AST levels, alongside the presence of anti-Jo-1 antibodies and the manifestation of dyspnea are significant biomarkers associated with the risk of developing IIM-ILD. This predictive model enhances early diagnostic cap","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"73"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic and economic barriers to initial specialist care for patients with rheumatoid arthritis: a scoping review.","authors":"Jack Ainsworth, Marita Bolic, Ibrahim Ismail, Zinat Mohammadpour, John Wood","doi":"10.1186/s41927-025-00501-2","DOIUrl":"10.1186/s41927-025-00501-2","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis is an autoimmune disease that can cause joint destruction, pain, loss of function, and reduced quality of life. Recent advancements in treatment have made it possible to control the impacts of this once-debilitating disease through early intervention. While numerous studies have examined barriers to rheumatoid arthritis care, no review has synthesized sociodemographic and economic factors across high-, upper middle-, and lower middle-income countries. This gap in the literature highlights the need for a comprehensive review that informs global health interventions. This review explores sociodemographic and economic barriers to initial specialist care for patients with rheumatoid arthritis.</p><p><strong>Methods: </strong>The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A search of CINAHL, MEDLINE, Scopus and Emcare was completed in May 2024.</p><p><strong>Results: </strong>Of the 5165 studies identified through the literature search, 121 full-text articles were reviewed, and 25 studies examining sociodemographic and economic barriers to specialist care were selected for analysis. A total of 17 high-income, one upper middle-income and seven lower middle-income countries were represented. Low socioeconomic status, low income and rurality were consistently reported as barriers to initial rheumatologist appointments across all countries in this review.</p><p><strong>Conclusion: </strong>These findings underscore the importance of addressing common barriers such as low socioeconomic status and rurality in global health interventions. Future large prospective studies are essential to better understand the relationship between sociodemographic factors and timely access to care.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"76"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interchangeability of patient pain, fatigue and global scores in patients with spondyloarthritis - a registry-based simulation study.","authors":"Stylianos Georgiadis, Daniela Di Giuseppe, Almut Scherer, Merete Lund Hetland, Gareth T Jones, Bente Glintborg, Anne Gitte Loft, Johan K Wallman, Brigitte Michelsen, Eirik Klami Kristianslund, Ayten Yazici, Merih Birlik, Jakub Závada, Michael J Nissen, Adrian Ciurea, Bjorn Gudbjornsson, Olafur Palsson, Ziga Rotar, Matija Tomšič, Heikki Relas, Johanna Huhtakangas, Ana Maria Rodrigues, Maria José Santos, Isabel Castrejon, Federico Díaz-González, Marleen van de Sande, Pasoon Hellamand, Lykke Midtbøll Ørnbjerg","doi":"10.1186/s41927-025-00527-6","DOIUrl":"10.1186/s41927-025-00527-6","url":null,"abstract":"<p><strong>Background: </strong>To investigate a patient-level single imputation approach for patient reported outcomes (PROs) that express similar contents or associated PROs, where a PRO whose value is missing at a particular timepoint is substituted by another PRO whose value is available at the same timepoint.</p><p><strong>Methods: </strong>We performed a simulation study on registry-based spondyloarthritis data to explore the potential interchangeability between the patient pain (PPA) and fatigue (PFA) assessment scores and relevant Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) individual questions, and between PPA, PFA and patient global assessment (PGA). Performance was assessed per imputation method in terms of relative bias and coverage. Sample size, level of missingness and missing data pattern were included as parameters in the simulations.</p><p><strong>Results: </strong>All applied scenarios to interchange PPA with BASDAI question 2 (axial pain), BASDAI question 3 (peripheral joint pain/swelling) or their average failed. Interchangeability between PFA and BASDAI question 1 (fatigue/tiredness) was acceptable for partially (up to 50%) missing data. When interchanging patient assessment scores (PPA, PFA and PGA), we observed inconsistent results in terms of performance. The performance of the applied methods depended on the sample size and the level of missingness, but not heavily on the underlying missing data pattern.</p><p><strong>Conclusions: </strong>Interchanging PFA and the BASDAI fatigue question was justified for partially missing data, while interchangeability between PPA, PFA and PGA, and between PPA and the BASDAI pain questions was not advised. Our findings suggest that registering patient assessment scores and BASDAI questions is recommended.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"75"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis.","authors":"Jun Yan, Hua Guo, Lin-Xin Zhang, Pei Chen, Yong-Ku Du, Juan Li, Ya-Ya Gao, Nan Ye","doi":"10.1186/s41927-025-00538-3","DOIUrl":"10.1186/s41927-025-00538-3","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint destruction and systemic inflammation, both of which significantly impair patients' quality of life. Mild cognitive impairment (MCI), a reversible precursor to dementia, is increasingly prevalent among elderly RA patients. Early identification of MCI in this population allows for timely interventions to slow cognitive decline.</p><p><strong>Objective: </strong>This study aims to identify independent risk factors for MCI in elderly patients with RA and to develop a predictive nomogram.</p><p><strong>Methods: </strong>We enrolled 378 elderly RA patients, aged 60 to 80 years, from Xi'an Fifth Hospital between December 2023 and December 2024. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with scores ranging from 20 to 26 indicating MCI. We analyzed demographic, clinical, and laboratory data to identify risk factors through logistic regression and constructed a nomogram. The model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Among the 378 patients, 94 (24.87%) were classified in the RA-MCI group. Multivariate analysis identified the course of disease (COD) (OR = 1.07, 95% CI: 1.03-1.10), elevated Disease Activity Score-28 (DAS28) (OR = 1.31, 95% CI: 1.13-1.53), high C-reactive protein (CRP) levels (OR = 1.01, 95% CI: 1.01-1.02), and osteoporosis (OP) (OR = 1.88, 95% CI: 1.14-3.13) as independent risk factors. The nomogram demonstrated moderate discrimination (AUC = 0.750, 95% CI: 0.696-0.805) and clinical utility.</p><p><strong>Conclusion: </strong>The COD, OP, DAS28, and CRP levels are key predictors of MCI in elderly RA patients. The proposed nomogram provides a practical tool for early risk stratification, facilitating targeted interventions to delay cognitive decline.</p><p><strong>Trial registration: </strong>This study conformed to the principles outlined in the Declaration of Helsinki and received approval from the Medical Ethics Committee of Xi'an Fifth Hospital (Approval No.: [2023] Ethics Review 55). Additionally, the trial was registered with the Chinese Clinical Trial Registry (Registration No.: ChiCTR2300077337, Registration Date: 2023-11-01). Written informed consent was obtained from all individual participants included in the study.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"69"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of lifestyle modification on metabolic pathways in older adults with overweight/obesity and rheumatoid arthritis: a secondary exploratory analysis of the SWET-RA study.","authors":"Grace Kim, Leanna M Ross, Alyssa M Sudnick, Johanna L Johnson, Carl F Pieper, Margery A Connelly, Olga Ilkayeva, Michael J Muehlbauer, Connie W Bales, Kathryn N Porter Starr, William E Kraus, Brian J Andonian, Kim M Huffman","doi":"10.1186/s41927-025-00525-8","DOIUrl":"10.1186/s41927-025-00525-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rheumatoid arthritis (RA) is associated with increased cardiometabolic risk due to inflammation and traditional risk factors, both of which can be mitigated by lifestyle modifications. This study examines metabolic pathways influenced by lifestyle changes and related to improved cardiometabolic risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a secondary exploratory analysis of the Supervised Weight loss and Exercise Training (SWET) study, in which twenty older adults with RA and overweight/obesity were randomized to 16 weeks of SWET or a counseling program. Baseline and post-intervention measures included mass spectrometry (MS) and nuclear magnetic resonance (NMR) metabolites and lipoproteins; cardiometabolic risk parameters; and RA clinical outcomes. Principal components analysis (PCA) reduced MS change scores into change factors. Between-group differences were assessed with t-tests and linear regression. Within-group differences were assessed with Wilcoxon-signed rank tests. Spearman's rank correlated MS change factors and NMR change scores with clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Group differences were minimal. In all participants, improvements in metabolic syndrome score were associated with increases in PCA Factor 1 (short- and medium-chain acylcarnitines) and ketone bodies (ρ=-0.57, unadjusted p = 0.009, adjusted p = 0.04; ρ=-0.45, unadjusted p = 0.049, adjusted p = 1.00) and decreases in large low-density lipoprotein particles (LDLp) and large high-density lipoprotein particles (HDLp) (ρ = 0.48, unadjusted p = 0.03, adjusted p = 1.00; ρ = 0.48, unadjusted p = 0.03, adjusted p = 1.00). Improvements in RA disease activity (DAS-28&lt;sub&gt;ESR&lt;/sub&gt;) were associated with reductions in very large triglyceride-rich lipoprotein particles (TRLp) (ρ = 0.60, unadjusted p = 0.01, adjusted p = 0.48). Improvements in patient-reported physical health were associated with reductions in HDL-c, ApoA1 concentrations, and medium HDLp (ρ=-0.50, unadjusted p = 0.03, adjusted p = 1.00; ρ=-0.47, unadjusted p = 0.04, adjusted p = 1.00; ρ=-0.45, unadjusted p = 0.047, adjusted p = 1.00). Improvements in patient-reported mental health were associated with decreases in high-density lipoprotein 6 (H6) particles (ρ=-0.60, unadjusted p = 0.03, adjusted p = 1.00), medium HDLp (ρ=-0.54, unadjusted p = 0.01, adjusted p = 0.48), and LDL size (ρ=-0.52, unadjusted p = 0.02, adjusted p = 0.96).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In older adults with RA and overweight/obesity, both intensive supervised weight loss and exercise and lifestyle-based counseling influenced metabolic pathways, enhancing lipid metabolism (e.g., reductions in large LDLp) and metabolic flexibility (e.g., increases in fasting ketones and short- and medium-chain acylcarnitines). However, reductions in HDL-related measures should be interpreted cautiously as they may not reflect improved cardiometabolic risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;ClinicalTrials","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"68"},"PeriodicalIF":2.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of salivary total antioxidant capacity and total oxidant status in patients with rheumatoid arthritis and systemic lupus erythematosus.","authors":"Mohadeseh Soltanian, Mohammad Hassan Kalantar Neyestanaki, Aida Mehdipour, Maryam Masoumi, Mohammad Aghaali, Ali Saleh, Mojtaba Hossein Nattaj","doi":"10.1186/s41927-025-00517-8","DOIUrl":"10.1186/s41927-025-00517-8","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress plays a critical role in the pathogenesis of autoimmune diseases, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Assessing total antioxidant capacity (TAC) and total oxidant status (TOS) in saliva offers a non-invasive method to evaluate oxidative stress and its relationship with disease severity. This study aimed to measure salivary TAC and TOS levels in RA and SLE patients and compare them with healthy controls.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving 90 participants: 30 RA patients, 30 SLE patients, and 30 healthy controls. Saliva samples were collected and analyzed using specialized TAC and TOS assay kits. Disease severity was evaluated using the Disease Activity Score-28 (DAS-28) for RA and the SLE Disease Activity Index (SLEDAI-2 K) for SLE. Statistical analyses included ANOVA, post-hoc tests, and Pearson correlation coefficients.</p><p><strong>Results: </strong>Results showed that RA and SLE patients had significantly higher oxidative stress compared to healthy controls, with lower TAC levels (RA: 298.88 ± 31.21 µM, SLE: 287.98 ± 38.07 µM, Control: 461.22 ± 158.22 µM, P < 0.001) and higher TOS levels (RA: 5.81 ± 1.28 µM, SLE: 5.80 ± 1.36 µM, Control: 3.49 ± 1.56 µM, P < 0.001). The TOS/TAC ratio was also significantly elevated in RA (1.95 ± 0.44) and SLE (2.05 ± 0.64) patients compared to controls (0.84 ± 0.44, P < 0.001). A positive correlation was observed between TOS levels and age (R = 0.256, P = 0.016), while no significant gender-based differences were detected.</p><p><strong>Conclusions: </strong>RA and SLE patients exhibit significant oxidative imbalance, as indicated by altered salivary TAC and TOS levels. These findings highlight the potential role of oxidative stress in these autoimmune diseases.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"67"},"PeriodicalIF":2.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of osteoporosis in chronic diseases: an umbrella review of 283 observational studies from 13 systematic reviews.","authors":"Víctor Juan Vera-Ponce, Jhosmer Ballena-Caicedo, Fiorella E Zuzunaga-Montoya, Joan A Loayza-Castro, Lupita Ana Maria Valladolid-Sandoval, Luisa Erika Milagros Vásquez-Romero, Stella M Chenet, Rafael Tapia-Limonchi, Carmen Inés Gutierrez De Carrillo","doi":"10.1186/s41927-025-00520-z","DOIUrl":"10.1186/s41927-025-00520-z","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is a disease characterized by decreased bone mineral density and deterioration of bone microarchitecture, which increases fracture risk. In the context of various chronic pathologies, this condition may present an even higher prevalence, impacting morbidity, mortality, and healthcare burden.</p><p><strong>Objective: </strong>To synthesize and compare available evidence from systematic reviews on the prevalence of osteoporosis across different chronic diseases.</p><p><strong>Methodology: </strong>An umbrella review following PRISMA guidelines was conducted, focusing on systematic reviews (with or without meta-analysis) reporting prevalence data of osteoporosis in adults with at least one chronic disease. Databases, including PubMed/MEDLINE, Scopus, Web of Science, and EMBASE, were searched, covering publications between 2009 and 2023, without language restrictions. Two independent reviewers performed study selection and data extraction, resolving discrepancies through consensus. A risk of bias assessment was conducted using the ROBIS tool. Prevalence estimates reported in each review were analyzed, classifying diseases according to the magnitude of the percentages found.</p><p><strong>Results: </strong>Thirteen systematic reviews were evaluated (twelve included meta-analyses). The highest prevalence of osteoporosis was observed in patients with Chronic Obstructive Pulmonary Disease (up to 36.8%) and diabetes mellitus (approximately 27.7%). Other conditions, such as rheumatoid arthritis, multiple sclerosis, liver cirrhosis, and celiac disease, showed variable prevalence but were equally relevant in clinical terms. Methodological heterogeneity, both in diagnostic criteria and populations, was a notable factor.</p><p><strong>Conclusions: </strong>The results highlight the need for systematic assessment of bone health in patients with chronic diseases, particularly those with a higher prevalence of osteoporosis. These findings underscore the importance of timely screening strategies and multidisciplinary approaches to prevent fractures and optimize comprehensive care.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9150,"journal":{"name":"BMC Rheumatology","volume":"9 1","pages":"66"},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}