AB0330 Osteoporosis, sarcopenia and osteosarcopenia in women with rheumatoid arthritis

Abstract

BackgroundRheumatoid arthritis (RA) is a systemic inflammatory disease associated with polyarthritis, progressive joint damage, and physical impairment that can lead to osteoporosis and sarcopenia, increasing the risk of fractures and leading to a greater loss of autonomy in RA patients.ObjectivesTo assess frequency of osteoporosis, sarcopenia and osteosarcopenia in women with RA.Methods40 female patients with RA (mean age 63±7 years) and 40 female controls without RA (mean age 64±9 years) were enrolled in this study. Body composition and bone mineral density (BMD) in lumbar spine and proximal hip were assessed by using dual X-ray absorptiometry (DXA, Hologic Discovery A). Sarcopenia in women was defined as a skeletal muscle index (SMI) ≤5.67 kg/m21 and osteosarcopenia – if sarcopenia and low BMD were present together.2 The participants performed Short Physical Performance Battery (SPPB) and handgrip strength was measured. Body mass index (BMI) and Disease Activity Score (DAS28) were calculated.ResultsLow BMD at least in one of measured area was found out in 19 (48%) RA persons and in 18 (45%) controls. Sarcopenia occurred in 10 (25%) RA patients and in 5 (12,5%) people without RA (p>0,05). Among them osteosarcopenia was found in 6 (15%) RA women and 2 (5%) controls. Skeletal muscle index (SMI) was lower in patients with RA (6.43±0.978) than in controls (7.01±1. 064, p<0,05). In RA patients SMI had a positive correlation with BMI (r=0,58, p<0,05) and handgrip strength (r=0,34 for right, r=0,30 for left, p<0.05 for both). Sarcopenia was more common in RA patients who were normal or underweight than in those who were overweight or obese according to their BMI (p<0.01). There was no correlation between SMI and DAS28, drug use, frequency of falls during the last year, SPPB in the RA groupConclusionsIn RA patients 48% had osteoporosis and 25% – sarcopenia, among them 15% women – osteosarcopenia. The risk of sarcopenia and osteosarcopenia was higher in nonobese patients.References[1] Cruz-Jentoft AJ, et al. Sarcopenia: European consensus on definition and diagnosis. Age and Agening2010;39:412–423.[2] Hassan EB, Duque G. Osteosarcopenia: A new geriatric syndrome. Aust Fam Physician2017Nov;46(11):849–853.Disclosure of InterestNone declared

Body composition in patients with rheumatoid arthritis: a narrative literature review

“…We found ten cross-sectional studies ( n = 40–457 RA patients) that specifically sought to evaluate the prevalence of sarcopenia in established RA. 70–79…”

“…We found ten cross-sectional studies (n = 40-457 RA patients) that specifically sought to evaluate the prevalence of sarcopenia in established RA. [70][71][72][73][74][75][76][77][78][79] Although sarcopenia seems to be more frequent in RA patients compared with controls, 15,16,63,64,66 it is difficult to provide conclusive evidence since the studies used different definitions for sarcopenia and involved different populations. In a cross-sectional study of 123 Moroccan RA patients (women: 87%; mean disease duration: 9.8 years; patients receiving csDMARDs: 90.2%; patients receiving bDMARDs: 8.1%), 70 the prevalence of sarcopenia was reported to be 39.8% (using the criteria proposed by Baumgartner et al 48 ), but muscle strength and physical performance were not evaluated.…”

Sarcopenia, immune-mediated rheumatic diseases, and nutritional interventions

“…Several cross-sectional studies have shown a higher prevalence of sarcopenia in patients with rheumatoid arthritis (RA) compared to healthy controls [20][21][22][23][24][25]. The prevalence of sarcopenia described in studies in patients with RA ranges from 7.8% [26] to 87.5% [24].…”

“…Confavreux et al [ 43 ] revised the systemic bone effects of biologic therapies in IMRDs (such as RA and ankylosing spondylitis). Feklistov et al [ 22 ] observed osteoporosis (low BMD) in a cross-sectional study among 48% of women with RA versus 45% in healthy controls. Sarcopenia (muscle mass, strength, and physical performance) was observed in 25% of RA patients, and osteosarcopenia (sarcopenia + low BMD) was found in 15%, versus 12.5% and 5% in healthy controls, respectively.…”