Sarcopenia, an independent predictor for all-cause mortality in rheumatoid arthritis: Insights from the NHANES database

Abstract

Sarcopenia, characterized by a decline in muscle mass and function, is increasingly recognized as a significant comorbidity in chronic diseases, including rheumatoid arthritis (RA). However, its relevance to all-cause mortality in RA patients remains to be explored. Here, we examine the correlation between sarcopenia and all-cause mortality in RA patients using the NHANES database. Data were obtained from 910 RA patients identified through self-reported data in the nationwide NHANES (1999–2018). Sarcopenia was defined by an appendicular skeletal muscle mass index adjusted for body mass index (ASM/BMI). Cox regression models were utilized to measure the connection between sarcopenia and all-cause mortality, adjusted for demographic, clinical, and lifestyle factors. Moreover, subgroup and sensitivity analyses were also performed. Sarcopenia was independently linked to a higher risk of all-cause mortality (HR = 1.610, 95% CI: 1.192–2.176, P = .002) after adjusting for potential confounders. Subgroup analysis showed significant associations in individuals aged <60 years, males, and those with comorbid conditions such as hypertension, diabetes, and cardiovascular disease. Additionally, sensitivity analysis confirmed the robustness of the findings. Sarcopenia was associated with a higher mortality risk in patients with RA, suggesting that its early identification and management may improve survival outcomes.