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

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Clinical Rheumatology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 05 May 2022

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.

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Data availability

All data generated or analyzed during this study were included in this published article.

Code availability

All data analysis was carried out using Statistical Package for Social Sciences (SPSS) v.23.0.

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Acknowledgements

We appreciate all the patients and professionals who enthusiastically participated in this study.

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Authors and Affiliations

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

    Yi-ran Chu, Sheng-qian Xu, Jian-xiong Wang, He-xiang Zong, Ke-ming Chen, Cong Wang, Wan-qiu Tong & Xi-le Wang

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  1. Yi-ran Chu
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  2. Sheng-qian Xu
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Contributions

Yi-ran Chu: conceptualization, methodology, formal analysis, investigation, data curation, writing—original draft. Sheng-qian Xu: conceptualization, methodology, validation, writing—review and editing, project administration. Jian-xiong Wang: supervision. He-xiang Zong: formal analysis, investigation. Ke-ming Chen: investigation, data curation. Cong Wang: data curation. Wan-qiu Tong: resources. Xi-le Wang: data curation.

Corresponding author

Correspondence to Sheng-qian Xu.

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The study protocol was approved by the Ethics Committee of Anhui Medical University, and all patients agreed to participate in this study.

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All participants signed an informed consent form prior to their participation in the study.

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Informed consent was obtained from all individual participants include in the study.

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Chu, Yr., Xu, Sq., Wang, Jx. et al. Synergy of sarcopenia and vitamin D deficiency in vertebral osteoporotic fractures in rheumatoid arthritis. Clin Rheumatol 41, 1979–1987 (2022). https://doi.org/10.1007/s10067-022-06125-y

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  • DOI: https://doi.org/10.1007/s10067-022-06125-y

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