Clinical and diagnostic patterns of the development of sarcopenia in patients with rheumatoid arthritis in combination with non-alcoholic fatty liver disease
Summary. Non-alcoholic steatohepatitis is often a concomitant pathology in rheumatoid arthritis. Studies indicate that about 15% of RA patients have signs of disease. Sarcopenia and non-alcoholic steatohepatitis in rheumatoid arthritis occurs in connection with the chronic inflammatory process, hormonal therapy and limitation of physical activity due to pain syndrome. The purpose of this work is to identify sarcopenia and its phenotype in patients with rheumatoid arthritis in combination with non-alcoholic steatohepatitis. Methods. All patients with RA were examined and diagnosed according to the EULAR/ACR 2010 diagnostic criteria, NASH diagnostic algorithm according to the unified clinical protocol of the Ministry of Health of Ukraine No. 826 dated November 6, 2014. We used the following EWCSOP2 recommended methods for diagnosing sarcopenia: SARC-F questionnaire, bioimpedance measurement, physical performance tests, dynamometry. The results. 72 patients with rheumatoid arthritis were examined. In 38 cases, sarcopenia was established. In 25 cases of diagnostic NASH in combination with sarcopenia. In most cases, it was found that the phenotype of sarcopenic obesity is characteristic of patients with RA and NASH — 66%, osteosarcopenia — 34% and osteosarcopenic obesity — 5%. Conclusion. NASH is quite often diagnosed in patients with RA in combination with sarcopenia, as they have common pathogenetic mechanisms and influence the course, severity and approaches to the treatment of the underlying pathology.
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