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[Evaluation of body composition and bone mineral density in women with rheumatoid arthritis].
Rev Assoc Med Bras (1992). 2007 Mar-Apr; 53(2):135-41.RA

Abstract

Decrease of bone mass and changes in body composition are common in patients with rheumatoid arthritis (RA) especially in users of glucocorticoids.

OBJECTIVE

To evaluate the bone mineral density (BMD) and its correlation to factors of body composition in women with RA.

METHODS

BMD and body composition (total and regional) were measured by DXA in 83 patients with rheumatoid arthritis. In addition, a lateral dorsal and lumbar spine x-ray was carried out as well as laboratory tests (rheumatoid factor, inflammatory exams). Information about activity of disease, functional class, physical activity and alimentary data were collected using specific questionnaires.

RESULTS

The prevalence of osteoporosis in menopausal patients was 21.4% (12 patients), of osteopenia 46.4% (26 patients) while 32.1% were normal (18 patients). Osteoporosis was similar in the lumbar spine and the femoral neck. More than half the patients showed low BMD in the lumbar and/or femoral neck. Non Caucasian and premenopausal women had the highest values of BMD averages. The cumulative dose of glucocorticoids for the last two years was a negative determinant of total lean mass. Age had a negative effect on BMD and body composition measurements. BMI showed a positive effect in all BC variables. Functional classes 3 and 4 had a negative effect only on the BMD total. Physical activity had a positive effect on BMD of the total femur. Duration of RA had a negative effect on BMD in the lumbar spine. The GC dose used in the last 3 months showed a negative effect on the total lean mass (MMT) and doses of the last 2 years had a positive effect on the total fat percentage (TFP). Finally, the estrogen exposure time (EET) indicated a positive effect on total fat percentage (TFP).

CONCLUSION

A decreased BMD found in 67.8% of patients suggests a better approach to prevention and treatment as from diagnosis of the disease. Age and non Caucasian race were negative factors for BMD values, while BMI was a positive factor for all BMD and body composition variables. The disease (RA) also had a negative influence on BMD of these women and use of GC produced changes in body composition, reducing the lean mass and increasing the fat percentage. Despite lack of evidence of a harmful direct action of oral corticoids on BMD, their use should be avoided. Therefore, preserving lean mass and enhancing BMD is important for these patients, in order to decrease fractures and falls.

Authors+Show Affiliations

Faculdade de Medicina, Universidade de São Paulo e Serviço de Reumatologia do Hospital Heliópolis, São Paulo/SP. raissajp@gmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

por

PubMed ID

17568917

Citation

Silva, Raíssa Gomes da, et al. "[Evaluation of Body Composition and Bone Mineral Density in Women With Rheumatoid Arthritis]." Revista Da Associacao Medica Brasileira (1992), vol. 53, no. 2, 2007, pp. 135-41.
Silva RG, Pippa MG, Zerbin CA. [Evaluation of body composition and bone mineral density in women with rheumatoid arthritis]. Rev Assoc Med Bras (1992). 2007;53(2):135-41.
Silva, R. G., Pippa, M. G., & Zerbin, C. A. (2007). [Evaluation of body composition and bone mineral density in women with rheumatoid arthritis]. Revista Da Associacao Medica Brasileira (1992), 53(2), 135-41.
Silva RG, Pippa MG, Zerbin CA. [Evaluation of Body Composition and Bone Mineral Density in Women With Rheumatoid Arthritis]. Rev Assoc Med Bras (1992). 2007 Mar-Apr;53(2):135-41. PubMed PMID: 17568917.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Evaluation of body composition and bone mineral density in women with rheumatoid arthritis]. AU - Silva,Raíssa Gomes da, AU - Pippa,Maria Guadalupe Barbosa, AU - Zerbin,Cristiano Augusto de Freitas, PY - 2006/04/26/received PY - 2006/11/06/accepted PY - 2007/6/15/pubmed PY - 2008/2/20/medline PY - 2007/6/15/entrez SP - 135 EP - 41 JF - Revista da Associacao Medica Brasileira (1992) JO - Rev Assoc Med Bras (1992) VL - 53 IS - 2 N2 - UNLABELLED: Decrease of bone mass and changes in body composition are common in patients with rheumatoid arthritis (RA) especially in users of glucocorticoids. OBJECTIVE: To evaluate the bone mineral density (BMD) and its correlation to factors of body composition in women with RA. METHODS: BMD and body composition (total and regional) were measured by DXA in 83 patients with rheumatoid arthritis. In addition, a lateral dorsal and lumbar spine x-ray was carried out as well as laboratory tests (rheumatoid factor, inflammatory exams). Information about activity of disease, functional class, physical activity and alimentary data were collected using specific questionnaires. RESULTS: The prevalence of osteoporosis in menopausal patients was 21.4% (12 patients), of osteopenia 46.4% (26 patients) while 32.1% were normal (18 patients). Osteoporosis was similar in the lumbar spine and the femoral neck. More than half the patients showed low BMD in the lumbar and/or femoral neck. Non Caucasian and premenopausal women had the highest values of BMD averages. The cumulative dose of glucocorticoids for the last two years was a negative determinant of total lean mass. Age had a negative effect on BMD and body composition measurements. BMI showed a positive effect in all BC variables. Functional classes 3 and 4 had a negative effect only on the BMD total. Physical activity had a positive effect on BMD of the total femur. Duration of RA had a negative effect on BMD in the lumbar spine. The GC dose used in the last 3 months showed a negative effect on the total lean mass (MMT) and doses of the last 2 years had a positive effect on the total fat percentage (TFP). Finally, the estrogen exposure time (EET) indicated a positive effect on total fat percentage (TFP). CONCLUSION: A decreased BMD found in 67.8% of patients suggests a better approach to prevention and treatment as from diagnosis of the disease. Age and non Caucasian race were negative factors for BMD values, while BMI was a positive factor for all BMD and body composition variables. The disease (RA) also had a negative influence on BMD of these women and use of GC produced changes in body composition, reducing the lean mass and increasing the fat percentage. Despite lack of evidence of a harmful direct action of oral corticoids on BMD, their use should be avoided. Therefore, preserving lean mass and enhancing BMD is important for these patients, in order to decrease fractures and falls. SN - 0104-4230 UR - https://www.unboundmedicine.com/medline/citation/17568917/[Evaluation_of_body_composition_and_bone_mineral_density_in_women_with_rheumatoid_arthritis]_ L2 - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302007000200018&lng=en&nrm=iso&tlng=en DB - PRIME DP - Unbound Medicine ER -