Risk factors for body composition abnormalities in systemic sclerosis

Abstract

The aim of this study was to evaluate the body composition (BC), bone mineral density (BMD), and the food intake in women with systemic sclerosis (SSc) compared to a control group, in order to identify main risk factors for BC abnormalities in SSc. Sixty-one SSc women and 67 age- and gender-matched controls were included. Spine, femur, and total body BMD measurements were performed using dual-energy X-ray absorptiometry. BC measurements included total lean (LM), fat mass (FM), and relative skeletal muscle mass index (RSMI) assessment. The food intake was calculated from 3-day food records and transformed into energy and nutrients. The 61 SSc patients [30 with diffuse cutaneous disease (dcSSc) and 31 with limited cutaneous SSc (lcSSc)] had significantly lower body mass index (BMI), LM, and FM, as well as lower BMD values compared to controls. Besides, the group with dcSSc, but not those with lcSSc, showed significantly lower BC and BMD measurements than controls. There was a significant inverse correlation between disease duration and BMI, LM, and RSMI. The total energy, macronutrients, and essential amino acids intakes were similar between patients and controls. After multivariate analysis, longer disease duration was the only risk factor associated with sarcopenia (RSMI below 5.45 kg/m(2); OR = 1.36, 95% CI 1.07-1.7). The present study showed an abnormal BC and a lower BMD, especially in dcSSc women, regardless of current food intake. Longer disease duration was associated with a higher risk of sarcopenia in SSc patients.

Obesity as a Risk and Severity Factor in Rheumatic Diseases (Autoimmune Chronic Inflammatory Diseases)

“…This lower percentage of obesity in SSc than in normal population was observed mainly in women with diffuse SSc, but not in those with limited SSc (123). In SSc patients, visceral abdominal fat has been correlated with cardiovascular risk factors and lung functionality, as already found in a large population of elderly men and women (124–126). …”

Exercise as an anti-inflammatory therapy for rheumatic diseases—myokine regulation

“…51 TNF and other proinflammatory cytokines, such as IL1β, have been suggested to induce loss of muscle mass directly by shift ing protein metabolism towards net catabolism and indi rectly by decreasing insulin sensitivity. 52 Although more common in patients with RA (known as rheumatoid cachexia), 51 reduced muscle mass is also associated with SLE, 53 systemic sclerosis, 54 inclusion body myositis 55,56 and ankylosing spondylitis. 57 Moreover, these patients often present with lower muscle strength and aerobic capacity, and higher levels of fatigue, when compared with healthy individuals.…”

Principles of Rehabilitation and Reactivation: Interstitial Lung Disease, Sarcoidosis and Rheumatoid Disease with Respiratory Involvement

“…These contrasting findings may be related to the underlying cause of myopathy; muscle sarcoidosis is rare, but typically responds well to systematic corticosteroid treatment [35], whereas steroid-induced myopathy may occur in other patients using corticosteroids to treat other disease manifestations. In SSc, skeletal muscle dysfunction is worse in those with longer disease duration, and in those with diffuse cutaneous SSc compared to limited cutaneous SSc [36]. There is also evidence of skeletal muscle vasculopathy in SSc, which may impair peripheral muscle function even in the absence of weakness [37].…”