ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1981

Increased Extracellular Water Measured By Bioimpedance Analysis in Polymyalgia Rheumatica Patients – Sign of Volume Overload

Florian Günther1,2, Boris P. Ehrenstein2, Martin Fleck1 and Rainer Straub1, 1Department of Internal Medicine I, University of Regensburg, 93042 Regensburg, Germany, 2Department of Rheumatology/Clinical Immunology, Asklepios Medical Center, 93077 Bad Abbach, Germany

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

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

Background/Purpose: Water retention is a typical feature of acute inflammatory episodes, chiefly implemented by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This is an important compensatory mechanism counteracting expected water loss, for example due to sweating. Both SNS and HPA axis are activated in polymyalgia rheumatica (PMR). As retention mechanisms may similarly apply in this disease, we hypothesized increased water retention in PMR.

Methods: Using bioimpedance analysis body composition was investigated in 56 healthy controls and 28 treatment-naive PMR patients. PMR patients were matched to healthy controls for age and weight. All PMR patients satisfied the 2012 EULAR/ACR classification criteria for PMR (including musculoskeletal ultrasound). 28 PMR patients were tested before and after 10 days of glucocorticoid based therapy (CRP and ESR markedly decreased). Correlations of extracellular water, systolic and diastolic blood pressure with parameters of inflammation were investigated in PMR patients as well as in healthy controls.

Results: Fat mass (fat free mass) was higher (lower) in PMR patients than controls, indicating sarcopenia and cachectic obesity in PMR patients (mean ± SD: 38.6 ± 6.7 versus 24.1 ± 5.4% of body weight, p < 0.001; 61.3 ± 6.7 versus 75.9 ± 5.4%, p < 0.001). Extracellular water (ECW) was markedly higher in PMR patients than controls (mean ± SD: 49.5 ± 6.2% versus 37.8 ± 2.6% of total body water, p < 0.001, Figure 1). Systolic and diastolic blood pressure were higher in PMR patients compared to controls, even before glucocorticoid treatment was initiated (mean ± SD: 146.9 ± 18.3 mmHg versus 119.3 ± 5.4 mmHg, p < 0.001; 84.4 ± 12.8 mmHg versus 78.0 ± 1.6 mmHg, p < 0.001). Extracellular water levels did not change in PMR patients upon 10 days of intensified treatment.

Conclusion: This study demonstrated increased extracellular water as sign of fluid overload in patients with PMR. These results indicate that volume changes are imprinted as long-lasting mechanisms as water distribution is not affected by short-term anti-inflammatory therapy.

Disclosure: F. Günther, None; B. P. Ehrenstein, None; M. Fleck, None; R. Straub, None.

To cite this abstract in AMA style:

Günther F, Ehrenstein BP, Fleck M, Straub R. Increased Extracellular Water Measured By Bioimpedance Analysis in Polymyalgia Rheumatica Patients – Sign of Volume Overload [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/increased-extracellular-water-measured-by-bioimpedance-analysis-in-polymyalgia-rheumatica-patients-sign-of-volume-overload/. Accessed .

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