身体成分的骨质疏松表型:类风湿性关节炎妇女的骨质疏松表型:与营养状况和身体状况的关系

O. Dobrovolskaya, A. Feklistov, M. Kozyreva, N. Toroptsova
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摘要

研究目的--评估类风湿性关节炎(RA)女性患者身体成分的骨质疏松表型与营养和身体状况的关系。共招募了 104 名患有类风湿性关节炎的女性(平均年龄为 59.5±8.7 岁)。检查包括临床、实验室和仪器(双能 X 射线吸收测量法)方法。营养状况采用迷你营养评估短表(MNA-SF)进行评估,体力状况采用国际体力活动问卷(IPAQ)、"椅子站立测试"、手握力、"定时上下楼测试 "和步速进行评估。38.5%的患者被诊断为骨质疏松表型。根据 MNA-SF 标准,51.0% 的女性患者存在营养不良和营养不良风险。根据 IPAQ,51.9% 的患者有低度和中度体力活动。在多变量逻辑回归分析中,确定了与骨质疏松症表型相关的独立因素:每天步行时间小于 30 分钟(几率比(OR)- 1.34;95% 置信区间(95% CI):0.11-17.32)、患者肌肉力量不足(0.11-17.32)、骨质疏松症表型(0.11-17.32)。32)、上肢肌力低(手握力低于 16 千克)(OR=7.12;95% CI:1.02-49.57)和下肢肌力低("椅子站立测试 "超过 15 秒)(OR=4.45;95% CI:1.08-18.42)、体重指数(BMI)低于 25 千克/平方米(OR=1.39;95% CI:1.04-1.85)。RA患者的身体成分中骨质疏松表型的发生率很高,其中近一半的受检者营养不足和/或体力活动减少。每天步行时间小于 30 分钟、上下肢肌肉力量较弱以及体重指数小于 25 kg/m2 与骨质疏松表型有关。
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Osteoporotic phenotype of body composition: Relationship with nutritional status and physical condition in women with rheumatoid arthritis
Aim of the study – to assess the relationship of the osteoporotic phenotype of body composition with nutritional and physical status in women with rheumatoid arthritis (RA).Material and methods. 104 women (average age 59.5±8.7 years) with RA were enrolled. The examination included clinical, laboratory and instrumental (dual-energy X-ray absorptiometry) methods. Nutritional status was assessed using the Mini Nutrition Assessment-Short Form (MNA-SF), physical status – using the International Physical Activity Questionnaire (IPAQ), “Chair stand test”, handgrip strength, “Timed Up and Go test” and gait speed.Results. Osteoporotic phenotype was diagnosed in 38.5% of patients. Malnutrition and risk of malnutrition according to MNA-SF had 51.0% of women. Low and moderate level of physical activity according to IPAQ – 51.9% of patients. In multivariate logistic regression analysis, independent factors associated with osteoporotic phenotype were determined: walking <30 minutes a day (odds ratio (OR) – 1.34; 95% confidence interval (95% CI): 0.11–17.32), low muscle strength of the upper extremities (handgrip strength less than 16 kg) (OR=7.12; 95% CI: 1.02–49.57) and lower extremities (“Chair stand test” more than 15 seconds) (OR=4.45; 95% CI: 1.08–18.42), body mass index (BMI) less than 25 kg/m2 (OR=1.39; 95% CI: 1.04–1.85).Conclusion. A high frequency of the osteoporotic phenotype of body composition was revealed in patients with RA, among whom almost half of the examined individuals had insufficient nutrition and/or reduced physical activity. Walking <30 minutes a day, low upper and lower limb muscle strength, and BMI<25 kg/m2 were associated with the osteoporotic phenotype.
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