Abnormal body composition phenotypes in rheumatoid arthritis: focus on biomarkers of muscle, adipose, and bone tissue

Objective: to study the association of muscle, adipose, and bone tissue markers with abnormal body composition phenotypes in women with rheumatoid arthritis (RA).

Material and methods. A total of 163 women (median age 61.0 [52.0; 66.0] years) with a confirmed diagnosis of RA were examined. Dualenergy X-ray absorptiometry was performed; based on the results, the following body composition phenotypes were identified: normal (NP), osteoporotic (OP), sarcopenic (SP), and osteosarcopenic (OSP). Serum levels of myostatin, insulin-like growth factor 1 (IGF-1), leptin (LEP), adiponectin (ADPN), resistin (RES), interleukin 6 (IL-6), irisin, and sclerostin (SOST) were measured.

Results and discussion. In patients with OP and OSP, LEP, RES, and SOST levels were significantly lower than in women with NP. In those with OSP, ADPN levels were higher than in patients with NP (p=0.031). IGF-1 levels in NP were significantly higher than in OP, SP, and OSP. Logistic regression showed an association of IGF-1 with OP, SP, and OSP (odds ratio, OR 0.96, 95% confidence interval, CI 0.93–0.99; OR 0.94, 95% CI 0.89–0.99; and OR 0.97, 95% CI 0.95–0.99, respectively; p<0.05). ADPN levels were associated with OP and OSP (OR 1.30, 95% CI 1.02–1.66 and OR 1.23, 95% CI 1.02–1.48, respectively; p<0.05); SOST levels associated with OP and OSP (OR 0.90, 95% CI 0.86–0.95 and OR 0.92, 95% CI 0.87–0.96, respectively; p<0.001); and LEP and RES levels with OP (OR 0.72, 95% CI 0.53–0.99 and OR 0.72, 95% CI 0.58–0.89, respectively; p<0.05).

Conclusion. Associations were identified between OP and levels of LEP, ADPN, RES, SOST, and IGF-1; between OSP and levels of ADPN, SOST, and IGF-1; and between SP and IGF-1 only. For IGF-1, the positive predictive value was 100% at the identified cut-off points, which allows it to be considered a predictive marker of abnormal body composition phenotypes in patients with RA.

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