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Background: Sarcopenia is one of the major health problems in older patients and is defined as a progressive decrease in muscle mass and function 1 . Sarcopenia has only rarely been studied in systemic sclerosis (SSc) and its impact in clinical characteristics of SSc is poorly investigated.
Objectives: To evaluate the associations between sarcopenia and clinical features in SSc patients.
Methods: Cross-sectional study, including 82 patients who met the ACR/EULAR 2013 classification criteria for SSc. Dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery were used to assess sarcopenia according the European Working Group on Sarcopenia in Older People’s (EWGSOP) diagnostic criteria updated in 2019 1 . Malnutrition was evaluated according to the European Society of Clinical Nutrition and Metabolism (ESPEN) 2 , using the Malnutrition Universal Screening Tool (MUST) to screen risk for malnutrition.
Results: The mean age was 60.4 years and 91.5% were women (
Clinical characteristics of SSc patients with and without sarcopenia. Data presented as number (%) of patients, except when indicated otherwise.
| Patients features | Whole
| SSc patients without sarcopenia
| SSc patients with sarcopenia
| P value |
|---|---|---|---|---|
| Females | 75 (91.5) | 62 (92.5) | 13 (86.6) | 0.606 |
| Caucasian | 68 (82.9) | 53 (79.1) | 15 (100) | 0.258 |
| Age (years) b | 60.4 (10.6) | 60.2 (10.3) | 61.5 (12.3) | 0.678 |
| Diffuse skin involvement | 16 (19.5) | 16 (23.8) | 0 (0) | 0.082 |
| Disease duration (years) a | 12.8 (7.5, 19.2) | 12.7 (7.1,19.2) | 13.4 (8.9, 19.8) | 0.324 |
| Rodnan skin score a | 4.0 (2.0, 10.0) | 5.0 (2.0, 10.0) | 2.0 (2.0,10.0) | 0.076 |
| Interstitial lung disease on HRCT | 32 (39.5) | 25 (37.3) | 7 (10.4) | 0.737 |
| FVC (% predicted) b | 88.4 (16.6) | 88.4 (16.9) | 88.3 (15.3) | 0.991 |
| DLCO (% predicted) b | 63.7 (11.9) | 63.6 (12.2) | 64.2 (11.2) | 0.855 |
| BMI (kg/m 2 ) b | 25.6 (4.6) | 26.5 (4.4) | 21.8 (4.1) | 0.001 |
| FFMI (kg/m 2 ) b | 15.6 (1.7) | 16.1 (1.6) | 13.8 (1.2) | <0.001 |
| FMI (kg/m 2 ) b | 9.5 (3.7) | 9.9 (3.6) | 7.5 (3.5) | 0.023 |
| Malnutrition | 12 (14.6) | 7 (10.4) | 5 (33.3) | 0.038 |
| MUST - Low risk | 58 (70.7) | 51 (76.1) | 7 (46.7) | 0.046 |
| Moderate and high risk | 24 (29.3) | 16 (23.9) | 8 (53.3) | |
| HAQ b | 0.778 (0.591) | 0.797 (0.575) | 0.833 (0.576) | 0.825 |
| Timed Up and Go test (s) a | 8.41 (7.41, 10.59) | 8.39 (7.5, 9.4) | 10.23 (7, 14) | 0.041 |
| Knee extension strength (kgf) a | 21.40 (15.65, 27.52) | 21.70 (18.05, 28.35) | 14.82 (9.5, 24) | 0.049 |
a Median (25, 75 th percentiles)
b Mean (standard deviation)
Abbreviations: BMI: body mass Index; DLCO: diffusion capacity of carbon monoxide; FFMI: fat free mass index; FMI: fat mass index; FVC: forced vital capacity; HAQ: Health Assessment Questionnaire; HRCT: high-resolution computed tomography; MUST: Malnutrition Universal Screening Tool; SSc: systemic sclerosis.
Conclusion: Sarcopenia is relatively common and is associated with malnutrition in patients with SSc. In our population, sarcopenia was not associated with other features related to a more severe disease. The role of sarcopenia in the prognosis of SSc needs to be better understood in longitudinal studies.
REFERENCES:
[1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
[2]Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015;34(3):335-40
Disclosure of Interests: Vanessa Hax: None declared, Rafaela Cavalheiro do Espírito Santo: None declared, Emerson Pena: None declared, Luísa Rodrigues: None declared, Renata Ternus Pedo: None declared, Jordana Miranda de Souza Silva: None declared, Nicole Pamplona Bueno de Andrade: None declared, Andrese Aline Gasparin: None declared, Ricardo Xavier Consultant of: AbbVie, Pfizer, Novartis, Janssen, Eli Lilly, Roche, Rafael Mendonça da Silva Chakr: None declared