Disease Activity, Inflammation Markers, and Quality of Life Are Associated with Muscle Strength in Croatian Rheumatoid Arthritis Patients—A National-Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Clinical and Lab Specifications
2.2. Sociodemographic Information
2.3. Disease Activity and Quality-of-Life Assessment
2.4. Muscle Strength Assessment
2.5. Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Females | Males | |||||||
---|---|---|---|---|---|---|---|---|
Remission + Low Disease Activity (N = 72) | Moderate Disease Activity (N = 88) | High Disease Activity (N = 73) | p | Remission + Low Disease Activity (N = 22) | Moderate Disease Activity (N = 5) | High Disease Activity (N = 7) | p | |
Disease duration (years), median (IQR) | 12 (13.5) | 14 (13) | 12 (12) | 0.867 | 10.5 (11) | 15 (14) | 7 (9.5) | 0.645 |
Age (years), median (IQR) | 54.5 (20) | 63 (12) | 68 (16) | <0.001 | 56 (13) | 63 (9) | 64 (12) | 0.071 |
Weight (kg), median (IQR) | 67.5 (15.4) | 73.85 (16.72) | 72 (18) | 0.068 | 82.85 (10.12) | 89 (3.6) | 75 (9.4) | 0.149 |
Height (cm), mean (SD) | 165.39 (6.21) | 163.89 (6.93) | 163.62 (5.92) | 0.097 | 177.95 (5.42) | 173 (7.68) | 174.43 (7.59) | 0.124 |
BMI (kg/m2), median (IQR) | 24.66 (6.48) | 27.23 (7.02) | 27.12 (6.14) | 0.013 | 26.25 (5.5) | 29.74 (3.6) | 25.2 (3.17) | 0.185 |
Muscle strength (kg) | 12 (7) | 10 (10) | 6 (9) | 0.002 | 20 (9) | 16 (9.25) | 17 (3.5) | 0.155 |
Exercise (yes), N (%) | 62 (86.11) | 57 (65.52) | 36 (49.32) | <0.001 | 16 (72.73) | 2 (40) | 6 (85.71) | 0.215 |
Arterial hypertension, N (%) | 22 (30.56) | 43 (48.86) | 46 (63.01) | <0.001 | 8 (36.36) | 3 (60) | 4 (57.14) | 0.465 |
Neurological disease, N (%) | 37 (51.39) | 17 (19.32) | 9 (12.5) | <0.001 | 9 (40.91) | / | 1 (14.29) | 0.119 |
Diabetes mellitus, N (%) | 2 (2.78) | 9 (10.23) | 9 (12.33) | 0.095 | 1 (4.55) | 3 (60) | 2 (28.57) | 0.009 |
Dyslipidaemia, N (%) | 7 (9.72) | 14 (15.91) | 15 (20.55) | 0.194 | 2 (9.09) | 4 (80) | 1 (14.29) | 0.002 |
Kidney disease, N (%) | 3 (4.17) | 3 (3.41) | 3 (4.11) | 0.961 | / | |||
Gastric ulcer disease, N (%) | 4 (5.56) | 14 (15.91) | 16 (21.92) | 0.018 | / | / | 1 (14.29) | 0.666 |
Liver disease, N (%) | 2 (2.78) | 1 (1.14) | 2 (2.74) | 0.709 | 1 (4.55) | / | / | 0.666 |
Pulmonary disease, N (%) | 2 (2.78) | 8 (9.09) | 1 (1.37) | 0.046 | 1 (4.55) | 1 (20) | / | 0.315 |
Coronary artery disease, N (%) | 2 (2.78) | 8 (9.09) | 9 (12.33) | 0.101 | / | 1 (20) | 1 (14.29) | 0.432 |
Peripheral vascular disease, N (%) | 3 (4.17) | 6 (6.82) | 4 (5.48) | 0.767 | / | |||
Inflammatory bowel disease, N (%) | 1 (1.39) | 2 (2.27) | 1 (1.37) | 0.878 | / | |||
NSAID, N (%) | 39 (54.17) | 43 (48.86) | 38 (52.05) | 0.795 | 13 (59.09) | 3 (60) | 5 (71.43) | 0.839 |
Paracetamol/tramadol, N (%) | 36 (50) | 54 (61.36) | 31 (42.47) | 0.053 | 6 (27.27) | 2 (40) | 2 (28.57) | 0.852 |
Corticosteroids, N (%) | 13 (18.06) | 46 (52.27) | 52 (71.23) | <0.001 | 4 (18.18) | 1 (20) | 6 (85.71) | 0.003 |
BDMARD, N (%) | 13 (18.06) | 10 (11.36) | 8 (10.96) | 0.360 | 4 (18.18) | 2 (40) | / | 0.199 |
CSDMARD, N (%) | 12 (16.67) | 61 (69.32) | 59 (80.82) | <0.001 | 6 (27.27) | 3 (60) | 6 (85.71) | 0.019 |
Number of medications ≤3, N (%) | 57 (79.17) | 42 (47.73) | 23 (31.51) | <0.001 | 18 (81.82) | 2 (40) | 1 (14.29) | 0.003 |
Number of medications >3, N (%) | 15 (20.83) | 46 (52.27) | 50 (68.49) | <0.001 | 4 (18.18) | 3 (60) | 6 (85.71) | 0.003 |
Tender joint number, median (IQR) | 0 (0) | 6 (4) | 14 (8) | <0.001 | 0 (2) | 4 (8) | 14 (8.5) | <0.001 |
Swollen joint number, median (IQR) | 0 (0) | 2 (3.25) | 9 (4) | <0.001 | 0 (0) | 2 (2) | 6 (7) | <0.001 |
ESR (mm/h), median (IQR) | 9 (6) | 15 (10.25) | 30 (26) | <0.001 | 8 (8.75) | 14 (6) | 13 (26.5) | 0.021 |
DAS VAS, median (IQR) | 10 (39) | 50 (28.75) | 50 (25) | <0.001 | Too few data points | |||
DAS-28 score, median (IQR) | 1.88 (0.75) | 4.24 (0.82) | 6.1 (0.98) | <0.001 | ||||
Mobility—no problem, N (%) | 24 (33.33) | 22 (25) | 9 (12.33) | 0.0482 | 5 (22.73) | 1 (20) | 2 (28.57) | 0.932 |
Mobility—some problem, N (%) | 47 (65.28) | 63 (71.59) | 61 (83.56) | 17 (77.27) | 4 (80) | 5 (71.43) | ||
Mobility—extreme problems or unable to move, N (%) | 1 (1.39) | 3 (3.41) | 3 (4.11) | / | ||||
Self-care 1, N (%) | 34 (47.89) | 33 (37.5) | 13 (17.81) | <0.001 | 9 (40.91) | 2 (40) | 3 (42.86) | 0.388 |
Self-care 2, N (%) | 37 (52.11) | 47 (53.41) | 49 (67.12) | 13 (59.09) | 3 (60) | 3 (42.86) | ||
Self-care 3, N (%) | / | 8 (9.09) | 11 (15.07) | / | / | 1 (14.29) | ||
Usual activities 1, N (%) | 30 (41.67) | 23 (26.14) | 7 (9.86) | <0.001 | 7 (31.82) | 2 (40) | 4 (57.14) | 0.187 |
Usual activities 2, N (%) | 42 (58.33) | 60 (68.18) | 57 (80.28) | 15 (68.18) | 3 (60) | 2 (28.57) | ||
Usual activities 3, N (%) | / | 5 (5.68) | 7 (9.86) | / | / | 1 (14.29) | ||
Pain/discomfort 1, N (%) | 24 (34.78) | 6 (7.14) | 1 (1.39) | <0.001 | 7 (31.82) | / | / | 0.035 |
Pain/discomfort 2, N (%) | 45 (65.22) | 69 (82.14) | 62 (86.11) | 15 (68.18) | 4 (80) | 7 (100) | ||
Pain/discomfort 3, N (%) | / | 9 (10.71) | 9 (12.5) | / | 1 (20) | / | ||
Anxiety/depression 1, N (%) | 37 (56.92) | 36 (42.35) | 21 (29.17) | <0.001 | 12 (54.55) | 3 (60) | 4 (57.14) | 0.728 |
Anxiety/depression 2, N (%) | 28 (43.08) | 44 (51.76) | 46 (63.89) | 9 (40.91) | 1 (20) | 2 (28.57) | ||
Anxiety/depression 3, N (%) | / | 5 (5.88) | 5 (6.94) | 1 (4.55) | 1 (20) | 1 (14.29) | ||
Visual Analogue Scale, median (IQR) | 70 (31.25) | 59.5 (21.5) | 49 (15) | <0.001 | 69.23 (16.05) | 57.4 (21.16) | 55.57 (12.43) | 0.038 |
EQ5D index, median (IQR) | 0.7 (0.18) | 0.66 (0.18) | 0.59 (0.21) | <0.001 | 0.71 (0.14) | 0.6 (0.19) | 0.66 (0.19) | 0.315 |
CRP (mg/L), median (IQR) | 2 (2) | 3.9 (5.38) | 7.4 (12) | <0.001 | 2 (1.88) | 3.7 (0.4) | 5.2 (10.86) | 0.080 |
Hb (g/L), median (IQR) | 134.5 (11) | 132 (13.25) | 128 (13) | 0.003 | 147.41 (10.57) | 135.2 (11.34) | 137 (16.69) | 0.029 |
Predictor | Beta | SE | p |
---|---|---|---|
Weight (kg) | 0.295 | 0.085 | <0.001 |
Height (cm) | 0.243 | 0.077 | 0.002 |
Exercise (yes) | 2.085 | 1.036 | 0.053 |
BDMARD | −3.207 | 1.419 | 0.024 |
CSDMARD | −2.511 | 1.178 | 0.034 |
Number of medications ≥ 3 | −2.152 | 1.046 | 0.045 |
Number of tender joints | −0.242 | 0.074 | 0.001 |
Number of swollen joints | −0.362 | 0.106 | <0.001 |
ESR (mm/h) | −0.091 | 0.030 | 0.003 |
DAS-28 score | −1.053 | 0.336 | 0.001 |
Mobility difficulties | −3.701 | 1.123 | 0.001 |
Self-care difficulties | −3.556 | 0.822 | <0.001 |
Usual activities difficulties | −4.117 | 0.954 | <0.001 |
Pain/discomfort level | −2.697 | 1.0878 | 0.014 |
Anxiety/depression difficulties | −2.384 | 0.882 | 0.007 |
EQ-5D VAS | 0.077 | 0.027 | 0.005 |
EQ 5D index | 12.744 | 2.550 | <0.001 |
CRP (mg/L) | −0.075 | 0.035 | 0.031 |
Hb (g/L) | 0.141 | 0.045 | 0.002 |
Predictor | Beta | SE | p |
---|---|---|---|
Weight (kg) | 0.81091 | 0.20135 | <0.001 |
Height (cm) | 0.66743 | 0.21429 | 0.004 |
Anxiety/depression difficulties | −7.51868 | 3.27161 | 0.03 |
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Radić, M.; Vlak, I.; Vučković, M.; Rendulić Slivar, S.; Kadojić, M.; Stamenković, D.; Bobek, D.; Radić, J.; Gelemanović, A.; Belančić, A.; et al. Disease Activity, Inflammation Markers, and Quality of Life Are Associated with Muscle Strength in Croatian Rheumatoid Arthritis Patients—A National-Based Study. Medicina 2024, 60, 1406. https://doi.org/10.3390/medicina60091406
Radić M, Vlak I, Vučković M, Rendulić Slivar S, Kadojić M, Stamenković D, Bobek D, Radić J, Gelemanović A, Belančić A, et al. Disease Activity, Inflammation Markers, and Quality of Life Are Associated with Muscle Strength in Croatian Rheumatoid Arthritis Patients—A National-Based Study. Medicina. 2024; 60(9):1406. https://doi.org/10.3390/medicina60091406
Chicago/Turabian StyleRadić, Mislav, Ivan Vlak, Marijana Vučković, Senka Rendulić Slivar, Mira Kadojić, Doris Stamenković, Dubravka Bobek, Josipa Radić, Andrea Gelemanović, Andrej Belančić, and et al. 2024. "Disease Activity, Inflammation Markers, and Quality of Life Are Associated with Muscle Strength in Croatian Rheumatoid Arthritis Patients—A National-Based Study" Medicina 60, no. 9: 1406. https://doi.org/10.3390/medicina60091406