Journal of Hebei Medical University ›› 2025, Vol. 46 ›› Issue (8): 959-964.doi: 10.3969/j.issn.1007-3205.2025.08.015

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Correlation analysis of bone mineral density and bone metabolism index levels with sarcopenia in patients with rheumatoid arthritis of different severity

  

  1. 1.Department of Rheumatology and Immunology and Center for Difficult and Rare Diseases, 
    the Third People′s Hospital of Chengdu, Sichuan Province, Chengdu 610041, China; 
    2.Department of General Practice, the Third People′s Hospital of Chengdu, 
    Sichuan Province, Chengdu 610041, China

  • Online:2025-08-25 Published:2025-08-29

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Abstract: Objective To explore the correlation between bone mineral density (BMD), bone metabolism indexes and sarcopenia in patients with rheumatoid arthritis (RA) of different disease activity, so as to provide a theoretical basis for clinical practice. 
Methods A total of 97 RA patients who were treated in the Third People′s Hospital of Chengdu from December 2021 to December 2024 were selected and divided into the research group and the control group according to the occurrence of sarcopenia. Some inflammatory indexes, BMD and bone metabolism indexes of the patients were recorded. The RA of different severity (mild activity, moderate activity, severe activity) was evaluated according to DAS28 score. 
Results The prevalence rates of sarcopenia in RA patients with mild, moderate and severe activity were 42.86%, 62.22% and 80.64% respectively, with significant differences (P＜0.001). Correlation analysis showed that tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were positively correlated with sarcopenia (r=0.381, 0.615, P＜0.001), while lumbar BMD (T12-L2), serum bone alkaline phosphatase (BALP), β-C-terminal telopeptide of type I collagen (β-CTX), procollagen type Ⅰ N-terminal propeptide (PINP), N-terminal osteocalcin (N-MID), 25-hydroxyvitamin D3 ［25(OH)D3］ and parathyroid hormone (PTH) were negatively correlated with sarcopenia (r=-0.711, -0.370, -0.359, -0.717, -0.622, -0.554, -0.708, P＜0.001). Ordered logistics regression analysis showed that β-ALP, 25(OH)D3 and PTH were protective factors for sarcopenia in RA patients with different disease activity (OR=0.488, 0.776, 0.115). The area under the receiver operating characteristic (ROC) curve of combined indexes for predicting sarcopenia in RA patients was 0.984, with sensitivity and specificity of 0.920 and 0.946 respectively. 
Conclusion In patients with mild, moderate and severe rheumatoid arthritis, the more obvious the decrease of T12-L2, β-ALP, 25(OH)D3 and PTH, the higher the risk of sarcopenia. β-ALP, 25(OH)D3 and PTH are protective factors, and their combined detection has high predictive value for sarcopenia in RA patients. 

Key words: rheumatoid arthritis, sarcopenia, bone mineral density