肌萎缩
医学
荟萃分析
置信区间
内科学
类风湿性关节炎
优势比
观察研究
奇纳
系统回顾
物理疗法
梅德林
心理干预
精神科
政治学
法学
作者
Keith Tam,Matthew Wong‐Pack,Theodore Liu,Jonathan D. Adachi,Arthur Lau,Jinhui Ma,Αλεξάνδρα Παπαϊωάννου,Isabel B. Rodrigues
出处
期刊:Jcr-journal of Clinical Rheumatology
[Ovid Technologies (Wolters Kluwer)]
日期:2023-04-26
卷期号:30 (1): 18-25
被引量:4
标识
DOI:10.1097/rhu.0000000000001980
摘要
Sarcopenia is underrecognized in patients with rheumatoid arthritis (RA). Risk factors of sarcopenia and its impact on outcomes in RA patients are relatively unknown. We conducted a systematic review to identify factors and outcomes associated with sarcopenia in RA. We conducted this review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. We searched PubMed, Embase, CINAHL, and Web of Science databases by combining the following search concepts: (1) RA and (2) sarcopenia. Articles were included if they included RA patients, assessed for sarcopenia using a consensus working group definition, and assessed for clinical outcomes. Meta-analysis was performed using studies that shared the same sarcopenia definition and consistency in reporting patient or disease variables. Our search identified 3602 articles. After removal of duplicates, title and abstract screen, and full-text review, 16 articles were included for final analysis. All studies had observational study designs. The pooled prevalence of sarcopenia ranged from 24% to 30%, depending on the criteria for sarcopenia used. Factors associated with sarcopenia included higher 28-joint Disease Activity Scale scores (+0.39; 95% confidence interval, +0.02 to +0.77) and baseline methotrexate use (odds ratio, 0.70; 95% confidence interval, 0.51-0.97). Baseline glucocorticoid use had a positive correlation with sarcopenia in multiple studies. Several studies found lower bone mineral density and higher incidence of falls and fractures in patients with sarcopenia. Sarcopenia is prevalent in RA, and it may be associated with higher RA disease activity, lower bone mineral density, and increased falls and fractures. Therefore, early screening of sarcopenia in RA patients is important to incorporate into clinical rheumatology practice.
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