FRI0048 SARCOPENIA AND SARCOPENIC OBESITY ARE ASSOCIATED TO GLUCOCORTICOID USE AND CLINICAL AND SEROLOGICAL MARKERS IN RHEUMATOID ARTHRITIS

Abstract

Background: Sarcopenia play an important role in the quality of life, morbidity and mortality of the patients, especially in who suffer chronic disease. In rheumatoid arthritis (RA) sarcopenia risk is higher due to joint dysfunction, pharmacological therapy and chronic inflammation1; these conditions may induce changes in body composition such as an increase in visceral fat associated to reduced muscle mass. Recently emerge the concept of sarcopenic obesity, however the association to clinic characteristics and pharmacotherapy in RA has not been established. Objectives: We investigated the prevalence of sarcopenia and sarcopenic obesity, as well as the relationship with glucocorticoids (GCs) use and clinic characteristic of RA patients from southern Mexico. Methods: We carried out a cross-sectional study in 223 RA patients (89% women, mean age 44 years), all diagnosed according to ACR/EULAR 2010 criteria. The body composition was examined using a bioimpedance method (body weight, muscle mass, body fat, etc.). Abdominal obesity was defined by WHO criteria and the hand grip strength was evaluated by dynamometry. Sarcopenia was defined according to The European Working Group on Sarcopenia in Older People, as Skeletal Muscle Mass Index less than 5.45 kg/m2 in women and less than 7.26 kg/m2 in men, while sarcopenic obesity was defined by the presence of sarcopenia more abdominal obesity. The GCs use and dosage (prednisone and methylprednisolone) were analyzed reviewing the clinical records. Anti-cyclic citrullinated peptides (anti-CCP) antibodies, rheumatoid factor (RF) levels, high sensitivity C reactive protein (hsCRP), erythrocyte sedimentation rate (ESR) were determinate. The morning stiffness, clinic activity of disease (DAS28-ESR score) and disability index functional (HAQ-DI) were measurement. Results: In this study 86% of the population had sarcopenia and 44% sarcopenic obesity. The 62.8% under GCs therapy. The prednisone dosage was positively associated to sarcopenia (>5 mg/day; OR=4.3, p=0.003) and sarcopenic obesity (OR=3.2, p=0.06). The intramuscular pulse of methylprednisolone (40 mg/kg) was associated to sarcopenic obesity phenotype (OR=2.61, p=0.09). Regarding the clinical and serological markers in RA, high disease activity (DAS28-ESR score) was associated to sarcopenia (OR=6.6, p=0.01) and sarcopenic obesity (OR=6.3, p=0.02). The morning stiffness (p=0.03), RF (p=0.05), anti-CCP positive (p=0.03) and HAQ-DI score (p=0.04) were too associated, mainly to sarcopenic obesity. Conclusion: Sarcopenia and sarcopenic obesity are associated to GCs dosage and with serological and disease activity markers in RA patients from southern Mexico. So that is needed promote monitoring and management of sarcopenia and sarcopenic obesity in RA patients. Reference: [1] Torii M, Hashimoto M, Hanai A, et al. Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis. Mod Rheumatol. 2018;1-7. doi: 10.1080/14397595.2018.1510565 Disclosure of Interests: None declared