Body composition and serum fetuin-A levels in patients with rheumatoid arthritis
Evgeniy V. Papichev, Boris V. Zavodovsky, Larisa E. Sivordova, Yuri R. Akhverdyan, Yulia V. Polyakova, Irina A. Zborovskaya
Research Institute of Clinical and Experimental Rheumatology named after A.B. Zborovsky, Volgograd, Russia
e_papichev@mail.ru
Keywords: ревматоидный артрит, ревматическая кахексия, композитный состав тела, фетуин-А, костная ткань, тощая ткань, жировая ткань, индекс жировой массы, индекс безжировой массы, rheumatoid arthritis, rheumatoid cachexia, body composition, fetuin-A, bone tissue, lean tissue, fat tissue, fat mass index, fat-free mass index
Abstract
Background. Rheumatoid
cachexia is a pathological condition which appears in patients with
rheumatoid arthritis with low fat-free mass and normal or high body mass
index. Bone mass loss is one of the components of rheumatoid cachexia.
Fetuin-A, a major noncollagen protein of bone tissue, regulates bone
remodeling. Aim of the study was to investigate the prevalence of
rheumatoid cachexia and the association of serum fetuin-A level with
body composition components in patients with rheumatoid arthritis.
Material and methods. 110 patients (8 male and 102 female) with
rheumatoid arthritis were enrolled in our study. Serum fetuin-A level
was determined by ELISA. Dual-energy X-ray absorptiometry with Total
Body program was performed. The diagnosis of rheumatoid cachexia was
based on the next criteria: fat-free mass index less than 10th
percentiles with fat mass index above 25th percentiles. Results and
discussion. We observed rheumatoid cachexia in 25 patients (22,7 %).
According to the literature, such patients have an increased risk of
developing metabolic syndrome, arterial hypertension and mortality.
Positive significant ( p < 0,05) correlations were observed between
serum fetuin-A levels and right and left lower limb, trunk, gynoid
region, both lower limbs and total body bone mass. No statistically
significant relationships with other indicators were identified.
Fetuin-A negative dynamic in patients with rheumatoid arthritis may be
accompanied by the loss of bone mass, which requires the improvement of
therapeutic approach. Conclusions. Almost a quarter of patients with
rheumatoid arthritis have rheumatic cachexia. Positive correlation
between serum fetuin-A levels and lower limbs, trunk, gynoid region and
total body bone mass was observed.
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