Минеральная плотность костной ткани и аппендикулярная мышечная масса у больных ревматоидным артритом

Objective . To study the bone mineral density (BMD) and appendicular muscle mass (AMM), their interrelation and relationship with calcium intake and vitamin D level in women with rheumatoid arthritis (RA). Material and methods . 43 women (mean age 57.5 ± 7.0 years) with confirmed RA were included. All patients were interviewed using a special questionnaire. Dual-energy X-ray absorptiometry (DXA) of lumbar spine, hip and total body was performed, and dietary calcium intake and vitamin D blood serum levels were assessed. Results . Reduced BMD was detected in 76.8% of patients, including osteoporosis (OP) – in 23.3%, and osteopenia – in 53.5% of women. Low AMM was found in 11.6%, and reduced appendicular muscle index (AMI) was found in 18.6% of the examined patients. Women with low BMD had significantly lower AMM and AMI scores than patients with normal BMD. The average calcium intake was 737 mg per day, while it was lower in patients with OP compared to those with normal BMD (p = 0.038). Among all women, 56% of individuals needed additional calcium supplementation. The average level of vitamin D in the blood serum was 20.8 ng/ml, with the incidence of insufficiency – 48.8%, and deficiency – 41.9% without significant differences between individuals with OP, osteopenia and normal BMD. Conclusion . In women with RA, reduced BMD was found in 76.8%, reduced AMM – in 11.6%, and low AMI – in 18.6% of cases. Patients with low BMD had lower AMM and AMI than women with normal BMD. Calcium intake was significantly lower in patients with OP compared to those with normal BMD.