ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2961

Body Composition and Myokine Levels in Juvenile Dermatomyositis and Associations with Physical Function

Birgit Nomeland Witczak1, Kristin Godang2, Jens Bollerslev2,3, Thomas Schwartz4,5, Berit Flatø3,6, Ivar Sjaastad3,4,7 and Helga Sanner6,8, 1Oslo University Hospital, Institute for Experimental Medical Research, Oslo University Hospital, Oslo, Norway, Oslo, Norway, 2Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, 3Institute for Clinical Medicine, University of Oslo, Oslo, Norway, Oslo, Norway, 4Institute for Experimental Medical Research, Oslo University Hospital, Oslo, Norway, Oslo, Norway, 5Department of Infectious Diseases, Oslo University Hospital, Oslo, Norway, Oslo, Norway, 6Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway, 7Department of Cardiology, Oslo University Hospital, Oslo, Norway, Oslo, Norway, 8Norwegian National Advisory Unit on Rheumatic Diseases in Children and Adolescents, Oslo University Hospital, Rikshospitalet, Oslo, Norway, Oslo, Norway

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: adipose tissue, body mass, juvenile dermatomyositis, muscle strength and physical function

  • Tweet
  • Email
  • Print
Session Information

Date: Wednesday, November 8, 2017

Session Title: Pediatric Rheumatology – Clinical and Therapeutic Aspects III: Lupus, Dermatomyositis, and Scleroderma

Session Type: ACR Concurrent Abstract Session

Session Time: 11:00AM-12:30PM

Background/Purpose: JDM presents with proximal muscle weakness and atrophy is frequent. Still, body composition (BC) in JDM has not been widely studied, but is known to be unfavourably altered in other CTDs and associated with physical disability. It has also been proposed that monocyte chemoattractant protein-1 (MCP-1), acting as a myokine, may promote inflammation in skeletal muscle in idiopathic inflammatory myopathies. Aim of study was to compare BC and myokines in JDM patients with controls and explore associations between measures of BC and myokines with physical function outcomes.

Methods: 59 JDM patients and 59 age- and sex-matched controls were included. BC including total and appendicular lean mass (LM) and fat mass (FM), was measured by DXA. MCP-1 and IL-6 in serum were quantified. Functional outcomes were short form-36 physical component summary (SF-36), childhood or adult HAQ (CHAQ/HAQ), manual muscle testing (MMT-8) and 6 minute walking test distance (6 MWD). Multiple linear backward regression was used to identify indicators of appendicular lean mass (ALM) and appendicular fat mass percentage (AFM%) and to assess associations between physical function outcomes and ALM, AFM% and myokines.

Results: Table 1 presents characteristics, BC and myokine levels in patients and controls. Median disease duration was 16.8 years; 61% were female; 28% were on prednisolone or DMARDs at follow-up. Patients had significantly higher ESR, lower SF-36, MMT-8, 6 MWD, and physical activity than controls.

BMI was comparable in patients and controls (P=0.752). Patients had 8% lower total lean mass, 10.4% lower appendicular LM and 6% lower trunk LM compared to controls (all P’s ≤0.032).  Total body FM% was 10.6% higher, AFM% was 10.6% % higher and android:gynoid fat ratio was 34.3% higher in patients than controls (all P’s ≤0.017). MCP-1 and IL-6 were higher in patients than controls (P’s ≤0.017).

In JDM patients, MCP-1 was an independent indicator of ALM (ß=-0.041, 95%CI(-0.081, -0.001)) and CRP and DAS muscle independent indicators of AFM% (ß=0.8, 95%CI (0.3, 1.3); ß=1.3, 95%CI(0.3, 2.2)).

When identifying independent indicators of physical outcomes, ALM was associated with SF-36 and MMT-8 (ß=0.6, 95%CI(0.1, 1.0); ß=0.370, 95% CI(0.190-0.550)); AFM% with CHAQ/HAQ, MMT-8 and 6MWD (ß= -0.005, 95%CI(0.001, 0.009); ß=-0.132, 95%CI(-0.203, -0.062); ß=- 1.968, 95%CI (-2.931, -1.006)) and MCP-1 with CHAQ/HAQ and 6MWD (ß=0.004,  95%CI(0.001, 0.008) and ß=-1.512, 95%CI(-3.264, -0.241)).

Conclusion: JDM patients assessed after long-term disease duration had unfavorable alterations in BC compared with controls, including lower LM and higher FM percentage. MCP-1 was higher in patients compared with controls, and independently associated with lower ALM and poorer functional outcomes in patients. Low ALM and high AFM percentage were also independently associated with impaired physical function in patients.

 

Table 1. Characteristics and body composition data in JDM patients and controls.

JDM patients total

(n=59)

Controls

(n=59)

P-value

Age, years at FU

21.5 (15.4-34.8)

21.6(15.1-34.8)

0.413

DAS muscle at FU

1.0 (0.0-2.0)

NA

NA

DAS skin at FU

4.0 (2.0-5.0)

NA

NA

Physical exercise, hours/week (n=51)

4.0 (3.0-4.0)

5.0(3.5-5.0)

0.017

hs-CRP, ug/mL

0.98(0.28-2.54)

0.59(0.23-1.25)

0.183

ESR, mm (n=55)

6.0(3.0-9.5)

4.00(3.00-8.00)

0.025

CHAQ/HAQ

0.0 (0.0-0.3)

NA

NA

SF-36 PCS >13 years (n=51)

53.9 (46.4-58.2)

56.9 (52.8-59.7)

0.018

MMT-8

78 (75-80)

80 (80-80)

<0.001

6MWD, m (n=58)

592.3 (80.6)

649.4 (78.8)

<0.000

Antropometric parameters

Weight, kg

62.6 (20.1)

64.9(19.9)

0.383

Height, cm

165.5 (15.0)

167.5 (15.9)

0.095

BMI, kg/m2

22.3 (4.8)

22.5 (4.5)

0.752

DXA-derived measures

Total body LM, kg

41.3 (12.9)

44.9 (13.6)

0.008

ALM, kg

18.1 (6.5)

20.2 (6.9)

0.004

Trunk LM, kg

20.5 (6.28)

21.8 (8.65)

0.032

LMI, kg/m2

14.69 (2.53)

15.56 (2.63)

0.014

ALMI, kg/m2

6.39(1.43)

6.96 (1.50)

0.006

Total body FM, kg

19.4 (9.2)

18.0 (8.2)

0.364

AFM, kg

9.0 (4.0)

8.6 (3.4)

0.528

Total body FM percentage

31.2 (7.9)

28.2 (7.5)

0.017

Trunk FM percentage

29.9 (9.7)

27.0 (9.0)

0.082

AFM percentage

33.3 (9.5)

30.1 (8.1)

0.010

Android:gynoid fat ratio

0.49 (0.36)

0.36 (0.16)

0.008

Myokines

IL-6, pg/mL (n=54)

3.91 (3.17-5.74)

3.56 (2.53-4.49)

0.017

MCP-1, pg/mL (n=54)

34.69 (21.88)

25.34 (11.45)

0.006

Values are mean (SD) or median(IQR) or number(%); n: =59 pairs of patients and controls, or n=59 patients, unless otherwise stated.

AFM, appendicular fat mass; ALM, appendicular lean mass; ALMI, appendicular lean mass index; BMI, body mass index; CHAQ/HAQ, child  and adult health assessment questionnaire; hs-CRP, high sensitive c-reactive protein; DAS, disease activity score for JDM; DXA, dual x-ray absorptiometry; ESR, erythrocyte sedimentation rate; IL-6, interleukine 6; LM, lean mass; LMI, lean mass index; MCP-1, monocyte chemoattractant protein-1; MMT-8, manual muscle testing-8; 6 MWD, 6 minute walking test distance; NA, not applicable; SF-36 PCS , short-form- 36 physical component summary.


Disclosure: B. N. Witczak, None; K. Godang, None; J. Bollerslev, None; T. Schwartz, None; B. Flatø, None; I. Sjaastad, None; H. Sanner, None.

To cite this abstract in AMA style:

Witczak BN, Godang K, Bollerslev J, Schwartz T, Flatø B, Sjaastad I, Sanner H. Body Composition and Myokine Levels in Juvenile Dermatomyositis and Associations with Physical Function [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/body-composition-and-myokine-levels-in-juvenile-dermatomyositis-and-associations-with-physical-function/. Accessed February 3, 2023.
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/body-composition-and-myokine-levels-in-juvenile-dermatomyositis-and-associations-with-physical-function/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences