{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:35:52Z","timestamp":1785796552544,"version":"3.56.0"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,11,2]],"date-time":"2018-11-02T00:00:00Z","timestamp":1541116800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["IK2 CX000955"],"award-info":[{"award-number":["IK2 CX000955"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) is associated with adverse body composition profiles and low muscle density due to the accumulation of intramuscular fat. Linear regression was used to assess differences between RA patients and controls and to determine associations between muscle density, strength, and physical functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>, ages 18\u201370 years, and healthy control subjects underwent whole\u2010body dual x\u2010ray absorptiometry and peripheral quantitative computed tomography, in order to quantify the appendicular lean mass index (<jats:styled-content style=\"fixed-case\">ALMI<\/jats:styled-content>) and the fat mass index (<jats:styled-content style=\"fixed-case\">FMI<\/jats:styled-content>), visceral fat area, and muscle density. Dynamometry was used to measure hand grip strength and muscle strength at the knee and lower leg. Disability and physical functioning were measured using the Health Assessment Questionnaire (<jats:styled-content style=\"fixed-case\">HAQ<\/jats:styled-content>) and the Short Physical Performance Battery (<jats:styled-content style=\"fixed-case\">SPPB<\/jats:styled-content>). Linear regression analyses were performed to assess differences related to <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> and associations between muscle density, strength, and function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study group included 103 patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> (51 men) and 428 healthy control subjects. Among patients with RA, low muscle density was associated with higher disease activity, C\u2010reactive protein and interleukin\u20106 levels, greater total and visceral fat area, lower <jats:styled-content style=\"fixed-case\">ALMI<\/jats:styled-content> Z scores, physical inactivity, and long\u2010term use of glucocorticoids (&gt;1 year). Patients with low <jats:styled-content style=\"fixed-case\">ALMI<\/jats:styled-content> Z scores had lower muscle density Z scores compared with reference participants with similarly low <jats:styled-content style=\"fixed-case\">ALMI<\/jats:styled-content> scores. Low muscle density was independently associated with lower muscle strength, higher <jats:styled-content style=\"fixed-case\">HAQ<\/jats:styled-content> scores, and lower <jats:styled-content style=\"fixed-case\">SPPB<\/jats:styled-content> scores, after adjustment for <jats:styled-content style=\"fixed-case\">ALMI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FMI<\/jats:styled-content> Z scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The low muscle density observed in patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> was associated with low muscle mass, excess adiposity, poor strength, and greater disability. Interventions to address poor muscle quality could potentially affect important functional outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23550","type":"journal-article","created":{"date-parts":[[2018,2,26]],"date-time":"2018-02-26T15:12:37Z","timestamp":1519657957000},"page":"1727-1734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Intramuscular Fat Accumulation and Associations With Body Composition, Strength, and Physical Functioning in Patients With Rheumatoid Arthritis"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua F.","family":"Baker","sequence":"first","affiliation":[{"name":"Philadelphia VA Medical Center, Philadelphia, Pennsylvania and University of Pennsylvania 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