Nutritional Status and its Relation with Disease Activity in Rheumatoid Arthritis: A Study from North India

This study proposed to assess the nutritional status of RA patients and to study any impact of disease activity (as assessed by DAS 28 score) on it. In this study 150 cases of RA diagnosed according to 1987 revised ACR criteria were recruited. Patients with immunocompromised state (i. e. HIV, malignancy), malabsorption syndrome, chronic disease or autoimmune disorder other than RA, metabolic syndrome and /or having cachexia due to cause other than RA were excluded from the study. From each case DAS 28 was calculated. Nutritional status was calculated by measurement of BMI, triceps skin fold thickness, serum albumin and total cholesterol. Low BMI (<25 kg/m) and low albumin (<3.5 gm/dl) were found in 106/150 (70.67%) and 11/150 (7.33%) cases respectively. Anemia was found in 31/150 (20.67%) cases while low TSFT was present in 76/150 (50.67%) patients and low serum cholesterol in 126/150 (84%) cases. The markers of nutrition status (haemoglobin, BMI and serum albumin) showed significant change with disease activity (P<0.05 for each). Only TSFT and serum cholesterol did not have any significant alteration with DAS28 (p>0.05). Haemoglobin, BMI and serum albumin had significant negative correlation with disease activity parameters (DAS28 and ESR). This study concluded that RA patients having a higher disease activity (higher DAS28) had significantly lower hemoglobin concentration, BMI and serum albumin (p for trend <0.05). A significant negative correlation exists between markers of disease activity (DAS28 and ESR) and markers of nutrition (serum albumin, haemoglobin and BMI).