Nutritional status in patients with rheumatoid arthritis

Background. Some chronic diseases have been associated to an impairment of nutritional status. Objective. To analyze nutritional status and its relati on to dietary intake, disease activity and treatment in rheumatoid arthriti s. Patients and methods. We have included 93 patients (43 men and 50 women) and 93 age- and sex-matched healthy controls. The assessment of nutritiona l status included anthropometric (body mass index, tricipital skin fold and midarm muscular circumference) and biochemical (serum albumin, prealbumin and retinol binding protein) parameters. Dietary intake was calculated from a food frequency questionnaire. As a measure of disease activity, we used the Health Assessment Questionnaire, Ritchie index, tender and swollen join t count and C-reactive protein. Statistical analysis was performed in the w hole series and in every functional class. Results. In the whole series, mi darm muscular circumference and serum albumin were significantly lower in p atients than in controls. All anthropometric parameters and serum albumin w ere significantly lower in patients in functional class IV than in their re spective controls. The dietary intake of energy, carbohydrates, vegetal pro teins and lipids was higher in patients than in controls. Midarm muscular c ircumference and serum albumin had a significant inverse relation with dise ase activity parameters; body mass index, midarm muscular circumference and serum albumin correlated inversely with the cumulative dose of glucocortic oids. Conclusions. Patients with rheumatoid arthritis in functional class I V have an impairment of nutritional status without a deficient dietary inta ke. The differences found in other functional classes are explained by rheu matoid arthritis itself. Nutritional parameters are related to disease acti vity and glucocorticoid treatment. Joint Bone Spine 2001 68:403-9. (C) 2001 Editions scientifiques et medicales Elsevier SAS.