Background: Systemic sclerosis (SSc) is a multisystem autoimmune disease of complex etiopathogeny, heterogeneous in its phenotypic expression and with a limited prognosis (1). The loss of muscle mass is a serious consequence of many chronic diseases and also is observed in SSc (2). This body composition alterations results in weakness, limitations and physical disability (3). SARC-F simple questionnaire, validated, is a key diagnostic feature for the fast assessment of geriatric syndromes associated with skeletal muscle wasting. However, there is no data about the SARC-F in SSc.

Objectives: To assess the association between the SARC-F questionnaire with clinical features in patients with systemic sclerosis (SSc).

Methods: Ninety-four patients diagnosed with systemic sclerosis were recruited and evaluated. Sarcopenia was assessed by the SARC-F questionnaire. Clinical features as disease duration time, comorbidities, body mass index (BMI), functional capacity by the Health Assessment Questionnaire (HAQ), inflammatory markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), creatine phosphokinase (CPK), hemoglobin, creatinin and albumin) were medical record. Frequency analysis, descriptive analysis and Pearson’s correlation were performed. Statistical significance was considered as p<0,05.

Results: Of the 94 patients analyzed, most were women (87/94;92.6%) with mean age of 60.5±10.3 years, median disease duration time of 11.2 (7.5-18.9) and median number of comorbidities was 1.00 (1.00-2.00). The mean of BMI was 25.9±4.7 Kg/m ² . Twenty-one of the patients were classified as active or passive smokers, thirty-five said they were former smokers and thirty-eight never smoked. Sixty-nine (80, 2%) out of the ninety-four patients in the study had at least one type of comorbidity (mean 1, 44±1, 04). Eighty-three patients (88.3%) showed a SARC-F score without signs suggestive of sarcopenia (0-5) and eleven patients (11.7%) showed suggestive to sarcopenia (6-10). In HAQ, fifty-seven (60.6%) patients had mild incapacity, thirty-five (37.2%) had moderate incapacity, and two patients (2.2%) had severe incapacity. Higher SARC-F scores were associated with greater number of comorbidities (r=0.2; p=0.027), higher physical disability by HAQ (r= 0.5;p=0.000) and lower albumin levels (r= -0.3; p= 0.048). On other hand, SARC-F was not associated with time of diagnosis, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), creatine Phosphokinase (CPK), hemoglobin, hematocrit and creatinine.

Conclusion: SARC-F scores were associated with comorbidities, physical disability and lower albumin levels in systemic sclerosis patients. Considering that comorbidities, physical disability and the albumin deficit enhances the patient’s muscle loss, SARC-F appears to be a good tool to screen sarcopenia risk factors in systemic sclerosis patients. Longitudinal studies are necessary to validate the SARC-F questionnaire in this population.

REFERENCES:

[1]Hochberg MC et al. Sixth edit. (Elsevier, ed.). Philadelphia; 2015;

[2]Sakuma K et al. Pflügers Arch - Eur J Physiol. 2017;469(5-6):573-591.

[3]Caimmi C, et al. Clin Rheumatol. 2018;37(4):987-997.

Acknowledgments: We thank the Coordination for the Improvement of Higher Level Personnel (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES) institution, the Foundation for Research Support of the Rio Grande do Sul State (Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul—FAPERGS), the Research and Events Incentive Fund (Fundo de Incentivo à Pesquisa e Eventos—FIPE) of HCPA and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq).

Disclosure of Interests: Leonardo Santos: None declared, Rafaela Cavalheiro do Espírito Santo: None declared, Vanessa Hax: None declared, Rafael Mendonça da Silva Chakr: None declared, Ricardo Xavier Consultant of: AbbVie, Pfizer, Novartis, Janssen, Eli Lilly, Roche