Abstract
Background:Sarcopenia can be age associated (primary form) or secondary to chronic disorders, including rheumatic inflammatory disorders. Systemic sclerosis (SSc) is a chronic autoimmune rheumatic disease characterized by widespread vasculopathy, progressive fibrosis of the skin and other internal organs, such as lung, kidneys, gastrointestinal tract, cardiovascular system. Different from the other chronic rheumatic inflammatory disorders, sarcopenia has not been well evaluated in SSc patients.Objectives:To assess the body composition (BC) and to identify the frequency of sarcopenia (SP) in SSc patients.Methods:A total of 44 women who met the ACR/EULAR 2013 classification criteria were included. Mean age was 53,2 + 8,8 years. The median disease duration was 7,0 [4,0;12,0] years. 26 (59,1%) patients had limited and 18 (40,9%) - diffuse cutaneous subtype. Body composition was measured using Dual-energy X-ray absorptiometry (DXA) of whole body. The appendicular lean mass index (ALMI) was calculated as the ratio of appendicular lean mass (ALM) to height (kg/m2). Handgrip measurement and chair stand test were performed. Physical function was measured with the Short Physical Performance Battery (SPPB). SP was diagnosed in agreement with the 2019 revised consensus on definition and diagnosis of SP of the European Working Group on Sarcopenia in Older People 2 (EWGSOP2): handgrip <16kg, chair stand test > 15 seconds for 5 rises, ALM <15 kg or ALMI <5.5 kg/m2. Severe SP was detected if the patient additionally had gait speed ≤0.8 m/s or SPPB ≤ 8-point score. Overfat was defined as body fat percentage >35%.Results:The median bone mineral content was 2.0 [1.8; 2.2] kg, total lean mass - 39,5 [35,7; 45,5] kg, ALM - 16,3 [14,5;19,4] kg, ALMI – 6,5 [5,7; 7,2] kg/m2, trunk fat mass – 13,5 [9,1; 16,7] kg and total fat mass - 26,6 [20,1; 34,5] kg. Body fat percentage was 38,8% [34,2; 42,7].9 (20,5%) women had low ALM and low ALMI, 6 (13,6%) – only low ALM. Healthy BC was found in 5 (11,3%), low ALM or low ALMI – in 7 (15,9%), overfat – in 24 (54,5%), low ALM + overfat – in 8 (18,2%) patients. We found no differences in BC between SSc patients with limited and diffuse cutaneous subtype.Low muscle strength (SP probable) was found in 21 (47,7%) women, meanwhile confirmed SP (low muscle strength and muscle mass) was diagnosed in 10 (22,7%) patients, among them 5 (11,4%) persons had severe SP. No significant difference in SP frequency among patients with limited and diffuse cutaneous SSc 4 (15,4%) and 6 (33,3%), respectively, (p=0,27). Osteoporosis was found in 6 (60%) patients with SP without differences in SSc subtypes.Conclusion:Healthy BC was found only in 11,3% cases, while overfat - in 72,7% and low ALM – in 34,1% SSc patients. SP was detected in 22.7% of women, among them in half of cases - severe SP, without any differences between the limited and diffuse subtypes of the disease.Disclosure of Interests:None declared
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