Background and Objectives: Sarcopenia is a notable comorbidity of rheumatoid arthritis (RA), affecting about one third of patients. However, the characteristic of muscle function and its association with RA disease remains unknown. Materials and Methods: This cross-sectional study collected clinical data from a real-world Chinese RA cohort. Sarcopenia was defined as both myopenia and low muscle function (LMF). Myopenia was defined as appendicular skeletal muscle mass index (ASMI) < 7.0 kg/m² in men and <5.7 kg/m² in women. LMF was defined as low muscle strength (LMS, hand grip < 28 kg in men and <18 kg in women) or low physical performance (LPP, 6 m gait speed < 1.0 m/s). Results: Among 1125 RA patients recruited in this study, 928 RA patients were eligible for analysis. The prevalence of sarcopenia, myopenia, LMF, LMS, and LPP in all RA patients was 36.5%, 46.1%, 69.0%, 57.8%, and 37.1%, respectively. According to their trends in age and disease activity, there were 111 (11.9%) patients in the young (age < 50 years) and remission (CDAI ≤ 2.8) subgroup, 199 (21.4%) patients in the young and active (CDAI > 2.8) subgroup, 198 (21.3%) patients in the old (age ≥ 50 years) and remission subgroup, and 420 (45.2%) patients in the old and active subgroup. Compared with the two remission subgroups, respectively, the young and active subgroup had significantly lower grip strength, higher prevalence of sarcopenia, LMF, and LMS, and worse activity function. After adjustment for potential confounders, multivariate multinominal logistic regression analysis showed that the young and active subgroup was positively associated with sarcopenia (OR = 3.193, 95%CI: 1.477–6.899), LMF (OR = 2.390, 95%CI: 1.207–4.731), and LMS (OR = 3.520, 95%CI: 1.743–7.110). Conclusions: Worse muscle strength, rather than reduced physical performance, is more common in patients with active RA at a young age. It underscores the critical need for early identification and intervention of muscle dysfunction to improve their quality of life.

The protocol aims to standardize and simplify labial salivary gland biopsy (LSGB) in suspected Sjögren's disease (SjD) using a lip fixation device, enabling safe, efficient, and operator-independent procedures with reduced technical difficulty, especially for junior rheumatologists. We developed a step-by-step protocol encompassing preoperative assessment, antisepsis, local anesthesia, device-assisted lip stabilization, precise vertical incision (5-7 mm), blunt dissection, gland harvesting (minimum 4-6 glands), and standardized closure. The device consists of two clamp arms, an oval pressure ring (major axis 2.4 cm, minor axis 1.5 cm), a matching backing plate separated by a 2.1 cm gap, and a precision screw mechanism. After the patient was positioned supine on the bed, clinical inspection was performed, followed by a "go/no-go" assessment to exclude localized active infection, mucosal ulceration, significant debris, or lip masses. Triple antisepsis is performed with alcohol-free Type III povidone-iodine. Local infiltration anesthesia is administered away from the incision site. The lip is everted and stabilized by the device; a vertical incision is made parallel to the pressure ring axis, penetrating the epithelium while avoiding deep glands or muscle. Glands are identified as pale-yellow translucent spherules (1-2 mm) and harvested by blunt dissection. Closure is achieved with a single interrupted suture, and hemostasis is verified. The protocol enables solo performance, reduces procedure time compared with conventional methods (8.72 ± 1.88 min vs. 18.11 ± 2.65 min, p < 0.001), yields comparable complication rates between groups (all p > 0.05), and ensures acquisition of adequate tissue (>8 mm², focus score assessment feasible). The device's elastic compression prevents tissue injury despite secure stabilization, and predefined troubleshooting steps manage bleeding or suboptimal yield. This protocol standardizes LSGB with a fixation device, overcoming manual retraction challenges, reducing reliance on assistants, and supporting training and quality assurance in rheumatology, while maintaining diagnostic accuracy and patient safety.

The protocol aims to standardize and simplify labial salivary gland biopsy (LSGB) in suspected Sjögren's disease (SjD) using a lip fixation device, enabling safe, efficient, and operator-independent procedures with reduced technical difficulty, especially for junior rheumatologists. We developed a step-by-step protocol encompassing preoperative assessment, antisepsis, local anesthesia, device-assisted lip stabilization, precise vertical incision (5-7 mm), blunt dissection, gland harvesting (minimum 4-6 glands), and standardized closure. The device consists of two clamp arms, an oval pressure ring (major axis 2.4 cm, minor axis 1.5 cm), a matching backing plate separated by a 2.1 cm gap, and a precision screw mechanism. After the patient was positioned supine on the bed, clinical inspection was performed, followed by a "go/no-go" assessment to exclude localized active infection, mucosal ulceration, significant debris, or lip masses. Triple antisepsis is performed with alcohol-free Type III povidone-iodine. Local infiltration anesthesia is administered away from the incision site. The lip is everted and stabilized by the device; a vertical incision is made parallel to the pressure ring axis, penetrating the epithelium while avoiding deep glands or muscle. Glands are identified as pale-yellow translucent spherules (1-2 mm) and harvested by blunt dissection. Closure is achieved with a single interrupted suture, and hemostasis is verified. The protocol enables solo performance, reduces procedure time compared with conventional methods (8.72 ± 1.88 min vs. 18.11 ± 2.65 min, p < 0.001), yields comparable complication rates between groups (all p > 0.05), and ensures acquisition of adequate tissue (>8 mm², focus score assessment feasible). The device's elastic compression prevents tissue injury despite secure stabilization, and predefined troubleshooting steps manage bleeding or suboptimal yield. This protocol standardizes LSGB with a fixation device, overcoming manual retraction challenges, reducing reliance on assistants, and supporting training and quality assurance in rheumatology, while maintaining diagnostic accuracy and patient safety.

Growing research implicates the diet‐microbiota‐joint axis plays a key role in joint health. The Dietary Index for Gut Microbiota (DI‐GM) is a novel metric evaluating dietary effects on microbial communities, yet its potential link to rheumatoid arthritis (RA) is unestablished. This study aimed to assess the relationship between DI‐GM scores and RA. We conducted a cross‐sectional analysis of 29,656 participants using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2020. DI‐GM scores were derived from 24‐h dietary recalls, and RA status was defined by self‐reported physician diagnosis. Weighted logistic regression was used to evaluate the association between DI‐GM and RA prevalence. Among included participants (weighted mean age 44.01 years; 49.48% female), 7.16% reported RA. After comprehensive adjustment, a significant inverse correlation was observed: each unit increase in DI‐GM score correlated with a 5.7% decrease in the odds of RA prevalence (odds ratio [OR] = 0.943; 95% confidence interval [CI]: 0.898–0.991). Individuals scoring DI‐GM ≥ 7 exhibited a 27.2% lower odds of having RA compared to those scoring ≤ 4 (OR = 0.728, 95% CI: 0.576–0.920). Restricted cubic spline analysis indicated a linear dose–response relationship ( p for nonlinear = 0.304). Furthermore, no significant subgroup interactions were detected (all p for interaction > 0.05). Our study found that higher DI‐GM scores linearly associate with diminished RA prevalence among US adults, highlighting a potential link between diet‐modulated gut microbiota and RA.

Background and Objectives: Hand joint deformity remains a main cause impairing quality of life in rheumatoid arthritis (RA). This study aimed to investigate the association between biologic and targeted-synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) treatment and the prevalence of hand joint deformity in RA patients. Materials and Methods: This cross-sectional analysis included RA patients recruited between 2019 and 2024. Hand joint deformity was defined as the presence of specific deformity in any of 28 hand joints, including the metacarpophalangeal (MCP) joints I-V, proximal interphalangeal (PIP) joints I-V, and distal interphalangeal (DIP) joints II-V. The key exposure was the use of b/tsDMARDs. Multivariable logistic regression was used to assess the association between b/tsDMARDs treatment and hand joint deformity. Results: A total of 1083 RA patients with a mean age of 52.6 ± 12.4 years and a median disease duration of 5 (2,11) years were included. Hand joint deformity was present in 25.4% (275/1083) of patients. The top three deformed joint locations were PIP V (12.9%, 140/1083), PIP III (11.6%, 126/1083), and PIP IV (10.9%, 118/1083). The top three deformity types were ulnar deviation of MCP II-V (8.0%, 87/1083), boutonniere deformity of II-V fingers (6.8%, 74/1083), and swan neck deformity of II-V fingers (6.7%, 73/1083). In total, 17.4% (188/1083) of patients had received b/tsDMARDs. After 1:1 propensity score matching for age, sex, and disease duration, the prevalence of deformity was significantly lower in patients treated with conventional medicine (csDMARDs and/or GCs) add-on b/tsDMARDs compared to those treated with conventional medicine (27.1% vs. 61.7%, p < 0.001). Multivariable logistic regression analysis showed that b/tsDMARDs use was independently associated with a lower prevalence of hand joint deformity after adjusting for confounding factors (OR = 0.211, 95%CI: 0.129–0.345, p < 0.001). Conclusions: The use of b/tsDMARDs was independently associated with a lower prevalence of hand joint deformity in RA.