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Rheumatology Advance Access originally published online on July 13, 2009
Rheumatology 2009 48(9):1128-1132; doi:10.1093/rheumatology/kep165
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Early rheumatoid arthritis and body composition

Christina Book1, Magnus K. Karlsson2, Kristina Åkesson2 and Lennart T. H. Jacobsson1

1Department of Rheumatology, Malmö University Hospital and 2Department of Orthopaedics, Clinical and Molecular Osteoporosis Research Unit, Malmö University Hospital, Malmö, Sweden.

Correspondence to: Christina Book, Department of Rheumatology, Malmö University Hospital, SE-205 02, Malmö, Sweden. E-mail: christina.book{at}med.lu.se


  Abstract

Objectives. RA is associated with joint destruction and cardiovascular diseases (CVDs). Possible predictors for CVD are early changes in body composition. We therefore evaluated whether lean mass of arms and legs (LMAL), total body fat mass (BFM) or truncal fat distribution (TFD) are altered early in RA, and if so, which factors are associated.

Methods. We included 132 RA patients (95 women) with disease duration of <=12 months. Disease activity score (DAS28), HAQ, BMI, comorbidity, smoking and medications were recorded. Total and regional lean mass and fat mass were measured with DXA. Data were compared with 132 age- and gender-matched controls, and possibly associated factors were analysed in linear regression models.

Results. LMAL was low in patients for both women and men (P = 0.007 and <0.001, respectively). BMI (P = 0.012), BFM (P = 0.014) and TFD (P < 0.001) were higher than expected in RA women. In bivariate analyses, all adjusted for age and current smoking, disease duration was independently associated with low LMAL in women (P = 0.021). High BFM was associated with HAQ x disease duration in men (P = 0.033) and DAS28 in women (P = 0.011). High TFD was associated with a history of diabetes or CVD in men with RA (P = 0.005).

Conclusions. Low LMAL, high BFM and high TFD are present in early RA patients. The long-term significant consequences of these abnormalities need to be determined.

KEY WORDS: Early rheumatoid arthritis, Body composition, Cardiovascular disease, Lean mass, Fat mass

Submitted 13 January 2009; revised version accepted 20 May 2009.
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