Phenacetin and the Kidney
Authors: M. Segal
Journal: BMJ (1965)

<h3>Background</h3> Sarcopenia is a muscle disease which is characterized by loss of muscle mass and function. This condition is associated with chronic disease and ageing which predicts inability, hospitalization and death. <h3>Objectives</h3> Describe sarcopenia prevalence and risk factors in patients with reumathoid arthritis (RA) over 65 years of age. <h3>Methods</h3> <b>Design:</b> A case-control study. Subjects Cases: Recruitment was performed by random sampling between patients over 65 years of age with RA (ACR/EULAR 2010 criteria) attended at 4 Spanish University Hospitals. Controls: Recruitment of subjects without rheumatoid disease was performed asking for case patients who attended to medical center with a similar-age (age of range +/- 5 years) and same-gender person from same social or family environment. Variables: <b>The main variable was sarcopenia which was defined according to European Working Group on Sarcopenia in Older People (EWGSOP) 2019. Sarcopenia risk factors assessed were: economic status, malnutrition, measured with Mini Nutritional Assessment (MNA), dual-energy x-ray absorptiometry (DEXA) in spine and hip to osteoporose screening, toxic habits, comorbidities and Charlson index, physical activity measured with Global physical activity questionnaire (GPAQ) and Short Physical Performance Battery (SPPB).</b> Other variables were: haemoglobin, calcium, D and B12 vitamins, total proteins, albumin, C reactive protein, body mass index (BMI), polimedication, quality of life measured with EQ-5D and RA related factors, activity disease measured with DAS28, SDAI and CDAI; physical function measured with HAQ (Health assessment questionnaire) and global functional status according ACR criteria. <b>Statistical analysis:</b> Descriptive and multivariative analysis was performed to identify factors associated to sarcopenia in RA. <h3>Results</h3> 76 patients and 76 controls were included in the study, 120 were women (78,9%), with media ± SD of age 74,7 ±6,98 of media and 32 (21,1%) were men, with age 70,1 ±3,78 of media. In comparation with controls, RA patients presented more frequency of sarcopenia (30 [19,53%] vs 6 [3,94%]; p=0,005). RA patients who presented sarcopenia, were upper average age (p=0,001), worse results in Short Physical Performance Battery (SPPB) (p=0,037), higher DAS28 (3,55 ± 1,09 vs 2,78 ± 1,05; p=0,017), higher score HAQ (1,18 ± 0,79 vs 1,69 ± 0,68; p=0,024), worse score in EQ5D (0,27 ± 0,28 vs. 0,54 ± 0,25; p=0,001) and Visual analogic scale VAS EQ5D (45,7 ± 17,4 vs. 56,9 ± 17,6; p=0,035). By the way, RA patients presented lower levels of total proteins (p=0,018), worse results in MNA (p=0,001) and they performed less physical activity by GPAQ (p=0,011). Multivariative models (Table 1) identified as independent predictors of sarcopenia in RA: age (p=0,014), proteins levels (p=0,044) and disease activity measured by DAS28 (p=0,030). This model could explain 37% of sarcopenia in RA (R2=0,37). <h3>Conclusion</h3> Sarcopenia is more prevalence in over 65 years-old RA people. Older age and higher activity disease measured by DAS28 more risk of sarcopenia. Proteins levels have a protected association with sarcopenia. <h3>Disclosure of Interests</h3> None declared