Skip to main content

Advertisement

SpringerLink
Log in

Contribution of rheumatoid arthritis disease activity and disability to rheumatoid cachexia

  • Original Article
  • Published:
Modern Rheumatology

Abstract

This cross-sectional study was done to show how nutritional indices influence each other and the contributions made by inflammation to the development of rheumatoid cachexia. We studied 295 female patients with rheumatoid arthritis (RA). We chose five nutritional indices: body mass index (BMI), arm muscle area (AMA), triceps skinfold thickness (TSF), which were obtained via anthropometric measurements, and serum albumin and cholesterol. Clinical indicators of RA included disease duration, C-reactive protein (CRP) and Disease Activity Score 28 (DAS28). We performed a bivariate correlation test between the nutritional indices and multiple regression analysis for each nutritional index. Mean AMA was low, 87.3% of the normal value, whereas TSF was not different. Muscle protein expressed by AMA decreased according to RA duration, whereas visceral protein indicated by serum albumin decreased with an increase in RA activity. The continuation of inflammation appears to be essential for a decrease in muscle protein in rheumatoid cachexia. DAS28 showed a positive contribution to BMI in the regression model, and the increase in RA disease activity causes an increase in BMI via an accumulation of tissue fat.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mullen JL, Buzby GP, Matthews DC, Smale BF, Rosato EF. Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg. 1980;192:604–13.

    CAS  PubMed  Google Scholar 

  2. Paget J. On the nervous mimicry of organic diseases. Lancet. 1873;102:727–9.

    Article  Google Scholar 

  3. Walsmith J, Roubenoff R. Cachexia in rheumatoid arthritis. Int J Cardiol. 2002;85:89–99.

    Article  PubMed  Google Scholar 

  4. Summers GD, Deighton CM, Rennie MJ, Booth AH. Rheumatoid cachexia: a clinical perspective. Rheumatology. 2008;47:1124–31.

    Article  CAS  PubMed  Google Scholar 

  5. Roubenoff R, Roubenoff RA, Cannon JG, Kehayias JJ, Zhuang H, Dawson-Hughes B, et al. Rheumatoid cachexia: cytokine-driven hypermetabolism accompanying reduced body cell mass in chronic inflammation. J Clin Invest. 1994;93:2379–86.

    Article  CAS  PubMed  Google Scholar 

  6. Giles JT, Bartlett SJ, Anderson RE, Fontaine KR, Bathon JM. Association of body composition with disability in rheumatoid arthritis: impact of appendicular fat and lean tissue mass. Arthritis Rheum. 2008;59:1407–15.

    Article  PubMed  Google Scholar 

  7. Roubenoff R. Rheumatoid cachexia: a complication of rheumatoid arthritis moves into the 21st century. Arthritis Res Ther. 2009;11:108–9.

    Article  PubMed  Google Scholar 

  8. Fukuda W, Yamazaki T, Akaogi T, Hayashi H, Kusakabe T, Tsubouchi Y, et al. Malnutrition and disease progression in patients with rheumatoid arthritis. Mod Rheumatol. 2005;15:104–7.

    Article  PubMed  Google Scholar 

  9. Arnett FC, Edworthy SM, Block DA, McShane RJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;38:432–42.

    Google Scholar 

  10. Gibson RS Anthropometric assessment of body composition. In: Principles of Nutritional Assessment. New York: Oxford University Press, 1990; pp. 200–205

  11. Hosotani N, Okada T, Muto Y, Yamamori H, Tashiro T, Miwa Y, et al. Japanese anthropometric data 2001 (in Japanese). Eiyohyoka Chiryo. 2002;19:50–63.

    Google Scholar 

  12. Prevoo ML, van’t Hof MA, Kuper HH, vanLeeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38:44–8.

    Article  CAS  PubMed  Google Scholar 

  13. Blackburn GL, Bistrian BR, Maini BS, Schlamm HT, Smith MF. Nutritional and metabolic assessment of the hospitalized patients. J Parenter Enteral Nutr. 1977;1:11–22.

    Article  CAS  Google Scholar 

  14. Matsuda Y, Singh G, Yamanaka H, Tanaka E, Urano W, Taniguchi A, et al. Validation of Japanese version of the Stanford Health Assessment Questionnaire in 3763 patients with rheumatoid arthritis. Arthritis Rheum. 2003;49:784–8.

    Article  PubMed  Google Scholar 

  15. Escalante A, Haas RW, del Ricon I. Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation. Arch Intern Med. 2005;14:1624–9.

    Article  Google Scholar 

  16. Marcora SM, Chester KR, Mittal G, Lemmy AB, Maddison PJ. Randamized phase 2 trial of anti-tumor necrosis factor therapy for cachexia in patients with early rheumatoid arthritis. Am J Clin Nutr. 2006;84:1463–72.

    CAS  PubMed  Google Scholar 

  17. Metsios GS, Stavropoulos-Kalinoglou A, Douglas KMJ, Koutedakis Y, Nevill AM, Panoulas VF, et al. Blockade of tumour necrosis factor-α in rheumatoid arthritis: effects on components of rheumatoid cachexia. Rheumatology. 2007;46:1824–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by a research grant from the Ministry of Health Labor and Welfare Japan. We thank Dr. Eisuke Inoue (Department of Clinical Medicine, School of Pharmacy, Kitasato University) and Dr. Hiroshi Ohmizu (Chugai Pharmaceutical Co., Ltd.) for their advice on statistical analysis. We also appreciate the efforts of Michiko Yamada, Aika Fujita, and Tamaki Ota in collecting data.

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Department of Diabetes, Endocrinology and Rheumatology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, Kyoto, 605-0981, Japan

    Wataru Fukuda, Atsushi Omoto, Saori Oku & Toru Tanaka

  2. Division of Inflammation and Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Yasunori Tsubouchi, Masataka Kohno & Yutaka Kawahito

Authors
  1. Wataru Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Atsushi Omoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saori Oku
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Toru Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasunori Tsubouchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masataka Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yutaka Kawahito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wataru Fukuda.

About this article

Cite this article

Fukuda, W., Omoto, A., Oku, S. et al. Contribution of rheumatoid arthritis disease activity and disability to rheumatoid cachexia. Mod Rheumatol 20, 439–443 (2010). https://doi.org/10.1007/s10165-010-0306-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10165-010-0306-6

Keywords

Search

Navigation