POS1562 FACTORS ASSOCIATED WITH HANDGRIP STRENGTH IN YOUNG ADULTS WITH JUVENILE IDIOPATHIC ARTHRITIS

Abstract

BackgroundDecreased handgrip strength is associated with many adverse outcomes, including increased all-cause mortality, and is considered a key criterion for sarcopenia [1, 2].ObjectivesThe study aims to determine handgrip strength in young adults with juvenile idiopathic arthritis (JIA) and to detect factors associated with low handgrip strength.MethodsThe single-center, cross-sectional study included 46 young adults with JIA. Anthropometric and clinical characteristics were collected, including assessment of disease activity by DAS28 and JADAS27 indices and calculation of articular and extra-articular damage by JADI-A and JADI-E indices. To determine hand grip strength, dynamometry with Jamar hand dynamometer, three times for both hands with the time of rest and fixed the highest value, was used. Thresholds for reduced muscle strength were as follows: <27 kg for males; <16 kg for females. To determine the bone mineral density (BMD) and bone mineral content (BMC) dual photon X-ray absorptiometry (DXA) was done. Calculation of skeletal mass index (SMI=appendicular lean mass divided by height2) was counted. Logistic regression analyses estimated the associations of the following independent variables: age, sex, BMI, disease activity, articular and extra articular damage, BMD, BMC, on the dependent variable handgrip strength. Statistical significance was defined as a p-value <0.05.ResultsThe study involved 26 female and 20 male patients. The average age of the patients was 24.4±5 years; the average age at the onset of the disease was 10.1±4.4 years. Thirty-two patients had reduced muscle strength (70%). Factors associated with handgrip strength are presented in Table 1.Table 1.Univariate logistic regression analyses: factors associated with reduced handgrip strength in young patients with JIAVariableCoefficient, b±mP-valueOdds ratio, OR (95% CI)AUC (95% CI)Age, years0.073 ± 0.0660.262--Sexf0.75 (0.58 - 0.87)m-2.15 ± 0.800.000.12 (0.02 - 0.56)BMI, kg/m2-0.25 ± 0.120.0430.78 (0.61 - 0.99)0.74 (0.57 - 0.86)Disease duration, years0.17 ± 0.070.0201.18 (1.03 – 1.37)0.76 (0.60 – 0.89)ESR, mm/hour0.062 ± 0.0320.055--C-reactive protein, mg/l0.007 ± 0.0100.521--Disease activity by DAS280.49 ± 0.270.072--Disease activity by JADAS270.16 ± 0.070.0221.18 (1.02 – 1.35)0.77 (0.60 – 0.89)Current glucocorticoid use1.39 ± 0.870.109--Glucocorticoid cumulative dose, mg0.00026 ± 0.000150.081--Articular damage index JADI-A0.79 ± 0.390.0452.20 (1.02 – 4.75)0.78 (0.62 – 0.90)Extra-articular damage index JADI-E0.91 ± 0.480.059--Health Assessment Questionnaire, HAQ1.28 ± 0.760.092--BMD total, g/cm2-9.29 ± 3.640.0110.001 (0.000 - 0.12)0.77 (0.60 – 0.89)Fat arms, %0.086 ± 0.0430.0101.09 (1.02 - 1.16)0.78 (0.62 -0.90)Lean mass arms, g-1.14 ±0.340.0010.32 (0.16 – 0.63)0.94 (0.81 – 0.99)Fat legs, %0.093 ± 0.0350.0071.10 (1.03 - 1.17)0.77 (0.60 – 0.89)Lean mass legs, g-0.73 ± 0.220.0010.48 (0.31 – 0.74)0.96 (0.84 – 0.99)Appendicular lean mass, g-0.49 ± 0.140.0010.61 (0.46 -0.81)0.96 (0.84 -0.99)Lean mass total, g-0.00025 ± 0.000080.0010.9997 (0.9996-0.9999)0.94 (0.82 – 0.99)Skeletal mass index, kg/m2-2.29 ± 0.730.0020.10 (0.02 – 0.42)0.97 (0.86 – 0.99)ConclusionThe results of our study demonstrate a high prevalence of low handgrip strength, up to 70 % among young patients with JIA. In these participants, lower BMI, lower total BMD and arms, legs, total lean mass and SMI, longer disease duration, higher disease activity by JADAS27 and articular index damage JADI-A, and higher percentage fat were linked to reduced handgrip strength.