Osteoporos Sarcopenia.  2021 Dec;7(4):140-145. 10.1016/j.afos.2021.11.002.

Osteosarcopenia synergistically increases the risk of falls in patients with rheumatoid arthritis

• Tada M
• Yamada Y
• Mandai K
• Matsumoto Y
• Hidaka N

• KMID: 2524623
• DOI: http://doi.org/10.1016/j.afos.2021.11.002

Abstract

Objectives
Osteosarcopenia is defined as osteoporosis with sarcopenia. The impacts of osteosarcopenia on falls and fractures in rheumatoid arthritis (RA) patients were investigated using 4 years of data from a longitudinal study (CHIKARA study).
Methods
The patients were divided into 4 groups by their baseline status: no sarcopenia and no osteoporosis (SP-OP-); only sarcopenia (SP + OP-); only osteoporosis (SP-OP+); and both sarcopenia and osteoporosis (SP + OP+). Survival rates and Cox hazard ratios were analyzed using falls and fractures as endpoints, adjusted by age, sex, and body mass index.
Results
A total of 100 RA patients (SP-OP-: 44%, SP + OP-: 17%, SP-OP+: 28%, and SP + OP+: 11%) were enrolled; 37 patients had falls, and 19 patients had fractures. The fall-free and fracture-free survival rates were significantly lower in SP + OP+ (36.4%, 54.5%) than in SP-OP- (75.0%, 86.4%). The hazard ratio of falls was significantly increased in SP + OP+, by 3.32-fold (95%CI: 1.01–10.9), whereas in SP + OP- and SP-OP+, there were no differences compared to SP-OP-.
Conclusions
The survival rates with the endpoints of falls and fractures in RA patients with osteosarcopenia were lower during 4-year follow-up. The risk of falls increased with the synergistic effect of osteoporosis and sarcopenia.

Keyword

Osteosarcopenia; Sarcopenia; Osteoporosis; Falls; Rheumatoid arthritis