[Energy expenditure at rest in patients with active rheumatoid arthritis and malnutrition]

Malnutrition is found significantly more often in patients with rheumatoid arthritis than in the normal population. One of the contributing causes may be the elevated energy expenditure at rest found in the stage of increased activity of the disease. The aim of the present work was to evaluate the association between the activity of the disease, the presence of signs of malnutrition and the energy expenditure at rest. In 26 patients with rheumatoid arthritis stage I-IV, mean age 62.2 +/- 11.0 years the basic parameters describing the activity of the disease were assessed (sedimentation rate, C-reactive protein (CRP), the articular index according to Thompson) and the nutritional status (body mass index, total serum protein and albumin, the skinfold above the triceps, the circumference of the muscles of the arm). In all patients indirect calorimetry at rest on fasting was applied. The assessed value of the energy expenditure at rest (REE) was expressed as % BMR calculated according to the formula of Harris-Benedict. In the group of patients with a higher activity of the disease (CRP positive, n = 14) REE was significantly higher as compared with the other patients (109.4 +/- 13.3% vs. 98.7 +/- 9.3%, p < 0.05). In patients who suffered from obvious depletion of visceral protein (albumin less than 30 milligrams, n = 5) REE was significantly higher than in the remainder (117.8 +/- 13.8% vs. 101.3 +/- 10.4%, p < 0.05). In the whole group there was a less close, though statistically significant correlation between CRP and REE (correlation coefficient 0.463, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)