Differences in Body Composition in Myositis Patients and Healthy Controls Are Associated with Disease Activity and Duration, Inflammatory Status, Skeletal Muscle Involvement and Physical Activity

Sabina Oreska^1,2, Maja Spiritovic^1,3, Petr Cesak⁴, Ondrej Marecek⁵, Hana Storkanova^1,2, Hana Smucrova¹, Barbora Hermankova^1,3, Katerina Kubinova^1,2, Martin Klein^1,2, Lucia Vernerova^1,2, Olga Ruzickova^1,6, Karel Pavelka^1,2, Ladislav Šenolt^1,2, Herman F Mann^1,7, Jiri Vencovsky^1,8 and Michal Tomcik^1,2, ¹Institute of Rheumatology, Prague, Czech Republic, Prague, Czech Republic, ²Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic, ³Department of Physiotherapy, Faculty of Physical Education and Sports, Charles University, Prague, Czech Republic, Prague, Czech Republic, ⁴Body Composition Laboratory, Faculty of Physical Education and Sports, Charles University, Prague, Czech Republic, Prague, Czech Republic, ⁵Physiotherapy, Faculty of Physical Education and Sports, Charles University, Prague, Czech Republic, Prague, Czech Republic, ⁶Institute of Rheumatology, Department of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic, ⁷First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic, ⁸Department Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic, Prague, Czech Republic

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Disease Activity, myositis and physical activity

Session Information

Date: Sunday, October 21, 2018

Title: Muscle Biology, Myositis and Myopathies Poster I: Clinical Features and Disease Course

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Skeletal muscle, pulmonary and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition. The aim of this study was to assess body composition and physical activity of IIM patients and healthy controls (HC).

Methods: 54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; polymyositis (PM, 22) / dermatomyositis (DM, 25) / necrotizing myopathy (IMNM, 7)) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. Anthropometric parameters and body composition were assessed (by densitometry: iDXA Lunar, and by bioelectric impedance: BIA2000-M), and physical activity was evaluated using Human Activity Profile (HAP) questionnaire. Routine biochemistry analysis was performed after 8 hours of fasting. Disease activity was evaluated by MITAX and MYOACT activity score. Muscle involvement was evaluated by manual muscle test (MMT-8) and functional index 2 (FI2). Data are presented as mean±SD.

Results: Compared to HC, patients with IIM had a trend towards significantly increased body fat % (BF%) as assessed by iDXA (39.9±7.1 vs. 42.4±7.1 %, p=0.077), but significantly decreased lean body mass (LBM) as assessed both by iDXA (45.6±8.1 vs. 40.6±7.2 kg, p=0.001) and BIA (52.6±8.8 vs. 48.7±9.0 kg, p=0.023), and increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p<0.001). Higher ECM/BCM ratio reflects worse muscle predispositions for physical exercise, aerobic fitness/performance, and deteriorated nutritional status. Compared to HC, IIM patients had significantly lower bone mineral density (BMD: 1.2±0.1 vs. 1.1±0.1 g/cm², p<0.001). Disease duration negatively correlated with BMD (r=-0.392, p=0.004) and LBM-BIA (r=-0.272, p=0.047). Disease activity assessed by both MITAX and MYOACT positively correlated with LBM-BIA (MITAX: r=0.294, p=0.031; MYOACT: r=0.335, p=0.013) and LBM-DXA (MITAX: r=0.341, p=0.012; MYOACT: r=0.368, p=0.007), similarly as with basal metabolic rate (BMR; MITAX: r=0.336, p=0.014; MYOACT: r=0.351, p=0.010), and fat free mass (FFM; MITAX: r=0.338, p=0.014; MYOACT: r=0.356, p=0.009). CRP was positively associated with BF% assessed both by DEXA (r=0.276, p=0.035) and BIA (r=0.306, p=0.025). Higher BF%-DEXA was associated with worse physical endurance (FI2: r=-0.311, p=0.026) and worse ability to perform physical activity (HAP: r=-0.292, p=0.032). MMT-8 score negatively correlated with ECM/BCM ratio (r=-0.385, p=0.006).

Conclusion:

Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients, which are associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. These data could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance.

Acknowledgement: Supported by AZV-16-33574A, MHCR 023728 and GAUK 312218.

Disclosure: S. Oreska, None; M. Spiritovic, None; P. Cesak, None; O. Marecek, None; H. Storkanova, None; H. Smucrova, None; B. Hermankova, None; K. Kubinova, None; M. Klein, None; L. Vernerova, None; O. Ruzickova, None; K. Pavelka, None; L. Šenolt, None; H. F. Mann, None; J. Vencovsky, None; M. Tomcik, None.

To cite this abstract in AMA style:

Oreska S, Spiritovic M, Cesak P, Marecek O, Storkanova H, Smucrova H, Hermankova B, Kubinova K, Klein M, Vernerova L, Ruzickova O, Pavelka K, Šenolt L, Mann HF, Vencovsky J, Tomcik M. Differences in Body Composition in Myositis Patients and Healthy Controls Are Associated with Disease Activity and Duration, Inflammatory Status, Skeletal Muscle Involvement and Physical Activity [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/differences-in-body-composition-in-myositis-patients-and-healthy-controls-are-associated-with-disease-activity-and-duration-inflammatory-status-skeletal-muscle-involvement-and-physical-activity/. Accessed .

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