Sarcopenia in rheumatic and musculoskeletal diseases: pathophysiology, diagnosis, and management
Fedorchenko Y. Imanbayeva N. Khojakulova U. Assylbek M.I. Zimba O.
December 2025Springer Science and Business Media Deutschland GmbH
Rheumatology International
2025#45Issue 12
Sarcopenia, defined by the progressive decline of skeletal muscle mass, strength, and performance, is an important, yet often overlooked complication of rheumatic and musculoskeletal diseases (RMDs). It arises from a multifactorial interplay of chronic systemic inflammation, oxidative stress, hormonal dysregulation, mitochondrial dysfunction, and prolonged glucocorticoid therapy. Elevated pro-inflammatory cytokines, such as IL-6, TNF-α, and IL-1β, promote catabolic pathways, impair regeneration, and accelerate muscle degradation. The prevalence of sarcopenia in RMDs may reach 40%, particularly among patients with rheumatoid arthritis, osteoarthritis, and spondyloarthritis. Clinically, it contributes to frailty, disability, increased risk of falls and fractures, and higher mortality. Diagnostic assessment combines muscle strength and performance testing with imaging modalities, including DXA, CT, and ultrasound. Evidence supports multimodal interventions, integrating progressive resistance training, adequate protein intake (1.2–1.5 g/kg/day), and supplementation with branched-chain amino acids, calcium, and vitamin D. Anti-inflammatory agents such as biologic DMARDs may counteract muscle loss while chronic corticosteroid use exacerbates it. Early recognition and multidisciplinary management are essential to preserve muscle function, improve quality of life, and reduce long-term morbidity in patients with RMD-associated sarcopenia.
Glucocorticoids , Inflammation , Muscle atrophy , Nutrition , Resistance training , Rheumatic diseases , Rheumatoid arthritis , Sarcopenia
Text of the article Перейти на текст статьи
Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76018, Ukraine
Department of Internal Medicine N4, Astana Medical University, Astana, Kazakhstan
Department of Emergency Medicine and Nursing, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Neurology, Psychiatry, Neurosurgery and Rehabilitation, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Department of Social Health Insurance and Public Health, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
Medical Center ‘’Mediker’’, Shymkent, Kazakhstan
Department of Rheumatology, Immunology and Internal Medicine, University Hospital in Kraków, Kraków, Poland
National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Department of Pathophysiology
Department of Internal Medicine N4
Department of Emergency Medicine and Nursing
Department of Neurology
Department of Social Health Insurance and Public Health
Medical Center ‘’Mediker’’
Department of Rheumatology
National Institute of Geriatrics
Department of Internal Medicine N2
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026