Body composition and serum fetuin-A levels in patients with rheumatoid arthritis

Background. Rheumatoid cachexia is a pathological condition which appears in patients with rheumatoid arthritis with low fat-free mass and normal or high body mass index. Bone mass loss is one of the components of rheumatoid cachexia. Fetuin-A, a major noncollagen protein of bone tissue, regulates bone remodeling. Aim of the study was to investigate the prevalence of rheumatoid cachexia and the association of serum fetuin-A level with body composition components in patients with rheumatoid arthritis. Material and methods. 110 patients (8 male and 102 female) with rheumatoid arthritis were enrolled in our study. Serum fetuin-A level was determined by ELISA. Dual-energy X-ray absorptiometry with Total Body program was performed. The diagnosis of rheumatoid cachexia was based on the next criteria: fat-free mass index less than 10th percentiles with fat mass index above 25th percentiles. Results and discussion. We observed rheumatoid cachexia in 25 patients (22,7 %). According to the literature, such patients have an increased risk of developing metabolic syndrome, arterial hypertension and mortality. Positive significant (p < 0,05) correlations were observed between serum fetuin-A levels and right and left lower limb, trunk, gynoid region, both lower limbs and total body bone mass. No statistically significant relationships with other indicators were identified. Fetuin-A negative dynamic in patients with rheumatoid arthritis may be accompanied by the loss of bone mass, which requires the improvement of therapeutic approach. Conclusions. Almost a quarter of patients with rheumatoid arthritis have rheumatic cachexia. Positive correlation between serum fetuin-A levels and lower limbs, trunk, gynoid region and total body bone mass was observed.

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