Synergy of sarcopenia and vitamin D deficiency in vertebral osteoporotic fractures in rheumatoid arthritis

Yi-Ran Chu; Sheng-Qian Xu; Jian-Xiong Wang; He-Xiang Zong; Ke-Ming Chen; Cong Wang; Wan-Qiu Tong; Xi-le Wang

doi:10.1007/s10067-022-06125-y

Synergy of sarcopenia and vitamin D deficiency in vertebral osteoporotic fractures in rheumatoid arthritis

Clin Rheumatol. 2022 Jul;41(7):1979-1987. doi: 10.1007/s10067-022-06125-y. Epub 2022 Mar 6.

Authors

Yi-Ran Chu¹, Sheng-Qian Xu², Jian-Xiong Wang¹, He-Xiang Zong¹, Ke-Ming Chen¹, Cong Wang¹, Wan-Qiu Tong¹, Xi-le Wang¹

Affiliations

¹ Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, 230022, Anhui, China.
² Department of Rheumatology & Immunology, the First Affiliated Hospital of Anhui Medical University, No. 218, Ji-xi Road, Hefei, 230022, Anhui, China. xsqian-1112@163.com.

PMID: 35253099
DOI: 10.1007/s10067-022-06125-y

Abstract

Objectives: To explore the synergistic effect of vitamin D deficiency and sarcopenia on vertebral osteoporostic fracture (VF) in patients with rheumatoid arthritis (RA).

Methods: A total of 188 patients with RA and 158 control subjects were enrolled. Bone mineral density (BMD) at the total hip, neck of femur, lumbar vertebra 1-4, and skeletal muscle mass was measured by dual energy X-ray absorptiometry (DXA) and biological electrical impedance, respectively. Serum 25(OH)D was tested by electrochemiluminescence. The prevalence of VF and osteoporosis (OP) were compared between RA and controls. The synergism of sarcopenia and vitamin D deficiency on VF in patients with RA was tested by χ² test and logistic regression.

Results: The prevalence of OP at all measured sites and VF in RA patients were all higher than those in controls (P < 0.0001). The incidence of VF in RA either with sarcopenia or with vitamin D deficiency was higher than for those without sarcopenia or without vitamin D deficiency (χ² = 5.069, P = 0.027, χ² = 8.822, P = 0.001). Age, disease duration, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), DAS28, health assessment questionnaire (HAQ), Sharp score, and body mass index (BMI) were significantly different between RA with sarcopenia or not (P < 0.05). Logistic regression analysis found that age (OR = 1.095, 95%, CI: 1.044-1.150, P < 0.0001) was a significant risk factor for VF in patients with RA, while high skeletal muscle mass (SMI) (OR = 0.513, 95% CI: 0.327-0.804, P = 0.004) was a protective factor for VF in RA patients.

Conclusions: VF, sarcopenia, and vitamin D deficiency are common in patients with RA. Sarcopenia and vitamin D deficiency may be risk factors for the incidence of VF in RA patients.

Key points: • RA patients had a higher incidence of OP and VF, also a high prevalence of sarcopenia and vitamin D deficiency. • Vitamin D deficiency and sarcopenia may might have a synergistic effect on VF in RA. • Aging and sarcopenia are risk factors for VF in RA patients, and sarcopenia were associated with disease activity and structural damage.

Keywords: Osteoporosis; Rheumatoid arthritis; Sarcopenia; Vertebral osteoporostic fracture; Vitamin D deficiency.

MeSH terms

Absorptiometry, Photon / adverse effects
Arthritis, Rheumatoid* / complications
Arthritis, Rheumatoid* / epidemiology
Bone Density / physiology
Humans
Osteoporosis* / complications
Osteoporosis* / epidemiology
Osteoporotic Fractures* / epidemiology
Risk Factors
Sarcopenia* / complications
Spinal Fractures* / complications
Spinal Fractures* / epidemiology
Vitamin D Deficiency* / complications