Session Title: Systemic Sclerosis & Related Disorders – Clinical Poster III
Session Type: Poster Session (Tuesday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Systemic sclerosis (SSc) is a chronic autoimmune disease, characterized by microvascular damage and progressive fibrosis. Among clinical complications, abnormal body composition and sarcopenia have been reported in SSc patients (1,2). Nailfold videocapillaroscopy (NVC) is a safe diagnostic tool to assess microvascular progressive damage and may predict severe organ involvement in SSc (3).
The aim of this study was to evaluate body composition in SSc patients and assess possible differences between patients with specific NVC patterns of microangiopathy.
Methods: 42 patients (6 men and 32 women) fulfilling ACR 2013 criteria for SSc underwent NVC (Videocap, DS MediGroup, Milan) to assess their NVC patterns (“Early”, “Active” and “Late” pattern) (4) and dual-energy X-ray absorptiometry scan (DXA) (Lunar Prodigy) to evaluate body composition. In particular we analyzed: total mass, total lean mass, total fat mass, bone mineral content (BMC), and bone mineral density (BMD) in seven body areas (head, upper limbs, lower limbs, trunk, spine, ribs, pelvis). Sarcopenia was diagnosed in patients with reduced skeletal muscle index (RSMI) below 5.45 Kg/m2 for females and 7.25 Kg/m2 for males (5). Statistical analysis was performed by non parametric tests.
Results: The mean age of patients was 65±10 years, mean disease duration 18.5 ±7.2 years, mean Rodnan skin score (mRSS) 11.2±9.3, and mean RSMI 6.3±1.1 g/cm2. All the patients showed a NVC “scleroderma pattern”: in particular 15 patients showed the “Late” pattern, 15 patients the “Active” pattern and 8 patients the “Early” NVC pattern. The “Late” NVC pattern group comparing to “Early/Active” group showed significantly lower total mass (57280±8107 vs 67025±10456 gr, p=0.01), lean mass (34259±3266 vs 40532±7659 gr, p=0.04), RSMI (5.8±0.91 vs 6.5±1.0 g/cm2, p=0.02), BMC (1769±332 vs 2075±501 gr, p=0.04), trunk BMD (0.71±0.11 vs 0.88±0.13 g/cm2,p=0.05) and spine BMD (0.90±0.17 vs 1.05±0.15 g/cm2, p=0.008). No statically significant difference between the two group was observed regarding total fat mass, total body BMD and BMD at upper limbs, lower limbs, head, ribs and pelvis. Interestingly, 25% of SSc patients were found affected by sarcopenia, and the most of sarcopenic patients showed the “Late” NVC pattern (65%). Comparing age, disease duration, mRSS between sarcopenic and non sarcopenic patients there was no difference between the groups, but sarcopenic patients presented a statistically significant lower BMI (p=0.02).
Conclusion: This study demonstrates in SSc patients a relationship between a more severe microvascular damage (“Late” SSc pattern) and the body composition, characterized by lower weight, lower total lean mass, lower bone mineral content and sarcopenia, without any significant variation in total fat mass. These clinical conditions seem not to be associated with severity of skin involvement and/or disease duration.
References: 1. Caimmi C, et al. Clinical Rheumatology 2018;37:987-997. 2. Thais FM, et al. Clin Rheumatol 2013;32:1037-44. 3. Smith V, et al. J Rheumatol. 2013;40:2023-8. 4. Cutolo M, et al. J Rheumatol 2000;27:155-60. 5. Baumgartner RN, et al. Am J Epidemiol 1998;147:755-63.
To cite this abstract in AMA style:Veronica T, Paolino S, Sulli A, Gotelli E, Casabella A, Cattelan F, Carlotta S, Pizzorni C, Alessandri E, Cutolo M. Body Composition and Nailfold Videocapillaroscopy Patterns in a Cohort of Systemic Sclerosis Patients [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/body-composition-and-nailfold-videocapillaroscopy-patterns-in-a-cohort-of-systemic-sclerosis-patients/. Accessed March 29, 2020.
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