AB0358 Phenotypes of secondary sarcopenia in patients with rheumatoid arthritis

Background

Secondary sarcopenia may be caused by low physical activity, eating disorders, chronic inflammation. In patients with rheumatoid arthritis (RA), sarcopenia co-occurs with osteoporosis as well as obesity and, in most cases, both osteoporosis and obesity co-occur with sarcopenia. Therefore, 3 phenotypes of sarcopenia can be identified: sarco-osteoporosis, sarcopenic obesity, osteosarcopenic obesity.

Objectives

The aim of the research was to study the features of sarcopenia and her phenotypes in patients with RA. There were examined 40 women with stage II-III RA, Rtg stage II-III, functional limitation stage II. The patients average age was 40.7±2.25 years.

Methods

The algorithm for diagnosing phenotypes of sarcopenia recommended by the ^{European Working Group on Sarcopenia in Older People (2009)} was used. Body mass index was determined. Dynamometry (the measurement of hand-grip strength using handgrip dynamometer) was performed and the evaluation of physical fitness. Serum levels of leptin and creatine phosphokinase MM (CPK MM) fraction were determined. The dual-energy X-ray absorbtiometry DEXA (tocalculate a T-score) was performed

Results

According to the results of laboratory tests and methods of evaluating functional muscle disorders, 87.5% of patients were diagnosed with sarcopenia. The mean values of dynamometry were within 18.3±0.7 kg being significantly lower as compared to healthy individuals – 28.3±0.5 kg. After the evaluation of physical fitness, the average score was 7.9±0.7, while in healthy individuals, it was 11.3±0.4. The mean CPK MM concentration was 175±2.34 U/L, while in healthy individuals, it was 144±3.5 U/L. The average T-score were within the limits (– 1,83±0,17) SD and was significantly lower than in healthy (−0,56±0,10) SD. After conducting studies in 17 patients were diagnosed with osteosarcopenic obesity in 11 – sarco-osteoporosis, 7 – sarcopenic obesity, 5 patients sarcopenia has not been diagnosed.

Conclusions

RA leads to muscle metabolism disorders which result in the development of secondary sarcopenia. Therefore, a high-protein diet, physical exercise, namely aerobic exercise (swimming, cycling) and medical preparations that improve muscle metabolism should be included in therapeutic measures and preparations of calcium.

Disclosure of Interest

None declared