Associations between parameters of nutritional status and disease activity in patients with rheumatoid arthritis

In patients with rheumatoid arthritis (RA), the loss of body cell mass is observed, known as rheumatoid cachexia. Cachexia is associated with increased morbidity and premature mortality of RA patients.

The aim of the study was to assess the effect of chronic inflammation and disease activity on nutritional status in RA patients.

In 140 patients with RA (111 women, 29 men), RA activity was measured using the Disease Activity Score in 28 joints (DAS28) and using the Modified Health Assessment Questionnaire (M-HAQ). The nutritional status was assessed with the following parameters: serum albumin and total cholesterol (TC), body mass index (BMI), hand-grip strength (HGS), and tricipital skinfold thickness.

There was a significant association between the parameters of nutritional status and the markers of inflammatory disease activity (number of swollen and tender joints, C-reactive protein, hemoglobin) and physical disability (M-HAQ). Swollen joint count and M-HAQ were inversely correlated with several nutritional parameters. In patients with high disease activity, significantly lower HGS and serum albumin levels were observed. Advanced stages of the disease (erosive and/or long-standing RA) were associated with lower HGS and higher TC levels.

The nutritional status of RA patients is determined by the intensity of chronic inflammatory process observed in the course of the disease and by disease duration.