INVESTIGADORES
BRUN Lucas Ricardo Martin
congresos y reuniones científicas
Título:
Muscle involvement and prevalence of sarcopenia in patients with rheumatoid arthritis
Autor/es:
BRANCE ML; PONS-ESTEL BA; QUAGLIATO NJ; JORFEN M; BERBOTTO G; CORTESE N; RAGGIO JC; SOLDANO J; PALATNIK M; CHAVERO I; DIEGUEZ C; SÁNCHEZ A; DEL RIO L; DI GREGORIO S; BRUN LR
Lugar:
Quito
Reunión:
Congreso; 2019 PANLAR Meeting; 2019
Institución organizadora:
PANLAR
Resumen:
Introduction:Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized bysymmetric polyarthritis that can lead to joint deformity and disability. Inaddition, bone and muscle are also affected. Local osteoporosis develops firstand then, it can progress to generalized osteoporosis. Sarcopenia ischaracterized by a progressive and generalized loss of muscle mass andstrength. Aim: Evaluate the muscle mass and the prevalence of sarcopenia inpatients with RA. Patients y methods:Adults RA patients (n=105) of both sexes and 100 subjects as control group (CG)matched by age, sex and body mass index (BMI) were included. Exclusioncriteria: pregnancy, intestinal malabsorption, chronic liver or kidney disease,cancer and drug that could affect bone mass except glucocorticoids. Whole-bodycomposition was measured by dual-energy X-ray absorptiometry (DXA, Hologic DiscoveryWi). Sarcopenia was defined as low muscle mass (appendicular skeletal musclemass/height2 and low muscle function: muscle strength and/orphysical performance). Muscle strength was evaluatedby hand-grip strength (Baseline Hand Dynamometer, USA) in the dominant hand. The physical performance was evaluated bysit to stand, timed up and go and 8-foot walking test. The distribution of the data was evaluated withthe Shapiro-Wilk test and the differences between groups were analyzed usingthe Student's t test or the Mann-Whitney test, as appropriate. The contingencytables were evaluated with the Fisher test. Data were expressed as mean±SD andp<0.05 was considered significant. Results: No differences in age (CG: 52.1±12.6y, RA: 53.3±13.4 y), sex (CG: 84 female and 16 male, RA: 87 female and 18 male)and BMI (CG: 26.0±5.1, RA: 27.8±4.6) were found between groups. Lowerpercentage of lean mass was found in RA patients (CG: 59.5%, RA: 57.0%;  p=0.0120). In addition, lower muscle strengthand/or physical performance in RA were found (handgrip strength= CG: 26.4±8.3kg, RA: 17.7±8.9 kg, p<0.0001; sit to stand test= CG: 12.8±5.9 s, RA: 16.5±5.9, p<0.0001;timed up and go test= CG: 7.5±2.0 s, RA: 10.3±3.5 s, p<0.0001;8-foot walking test= CG: 1.07±0.27 m/s, RA: 0.79±0.23 m/s, p<0.0001).Therefore, higher prevalence of sarcopenia in RA group was found (CG: 8.1%; RA:44.3%; RR: 2.1; p<0.0001). While in the CG no there was no case of severesarcopenia, in the RA group 33% were found. Moreover,a higher percentage of total fat (GC:37.3±7.2%, RA: 40.9±6.8%, p=0.0062) and visceral fat (GC: 566.2±305.8 g, RA: 692.7±350.0 g, p=0.0090)were found in patients with RA. In conclusion, a higher prevalence of sarcopenia wasfound in the RA group with an increase in total and visceral fat. The activityof the disease, immobility and treatment with glucocorticoids would affect themuscle mass in patients with RA and this could even affect the jointaffectation, progressive loss of bone mass, greater risk of falls andconsequently increased risk of fracture.