Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function

• Published in: Clinical rheumatology Vol. 37; no. 3; pp. 607 - 614
• Main Authors: Santillán-Díaz, Cira, Ramírez-Sánchez, Noemi, Espinosa-Morales, Rolando, Orea-Tejeda, Arturo, Llorente, Luis, Rodríguez-Guevara, Gerardo, Castillo-Martínez, Lilia
• Format: Journal Article
• Language: English
• Published: London Springer London 01.03.2018; Springer Nature B.V
• Subjects: Adult; Aged; Arthritis, Rheumatoid - complications; Body composition; Body Composition - physiology; Body fat; Cachexia; Cachexia - diagnosis; Cachexia - epidemiology; Cachexia - etiology; Disabled Persons; Electric Impedance; Female; Folic acid; Humans; Male; Medicine; Medicine & Public Health; Methotrexate; Middle Aged; Nutritional status; Original Article; Physical activity; Prevalence; Rheumatoid arthritis; Rheumatology; Severity of Illness Index; Rheumatoid cachexia; Bioelectrical impedance vector analysis; Physical disability; Folic acid
• ISSN: 0770-3198; 1434-9949; 1434-9949
• DOI: 10.1007/s10067-017-3889-x

Rheumatoid arthritis (RA) patients frequently have changes in their body composition, with a decrease in muscle mass and an increase in fat mass, a syndrome that is termed rheumatoid cachexia (RC). The prevalence of this nutritional alteration is not well known; there is as yet no consensus, seeing as it depends on the methods, techniques, and cutoff points that are used for its diagnosis. The main aim of this study was to identify RC through assessment by bioelectrical impedance vector analysis (BIVA) and its association with metabolic causes, physical function, and the main disease status, among others. The prevalence of RC was identified in those subjects who fell outside the right lower quadrant of the reference curve of RXc graph of BIVA. Clinical, anthropometric, biochemical and physical activity, emotional status, and diet markers were also evaluated. Ninety-four patients were included (92.55% women). The prevalence of RC assessed by BIVA was 21.28%. BIVA-cachexia patients had a lesser value of handgrip strength vs. patients without BIVA-cachexia 10.2 kg (7.2–13.4) vs. 14.7 kg (9.6–19), p  = 0.0062. Disability and folic acid with methotrexate consumption are related to BIVA-cachexia ((OR 4.69, 95% CI 1.33, 16.54, p  = 0.016) and (OR 0.19, 95%CI 0.058, 0.651, p  = 0.008), respectively). BIVA could represent a valuable tool to assess presence of RC. It is important that RA patients have physical therapy to improve their nutritional status.