Session Type: Abstract Submissions (ACR)
Background/Purpose: Sarcopenia is more frequent in RA patients than in general population, probably due to persistent inflammatory state. The impact of inflammatory burden seem to be higher in appendicular lean mass than in trunk lean mass, and it could be evaluated using the trunk-to-appendicular lean mass ratio. The aim of this study was to determine whether LBM distribution, in particular trunk-to-appendicular lean mass ratio, is associated with HRQoL in RA patients.
Methods: This cross-sectional study was conducted in consecutive RA patients seen in our Rheumatology Department from January 2012 to June 2013. An interview, chart review, physical examination, laboratory tests and dual energy X-ray absorptiometry (DXA) were performed. RA was defined using the ACR criteria; LBM was determined by DXA and it was analyzed as subtotal LBM (whole body excluding the head), trunk LBM, appendicular LBM and trunk to appendicular lean mass ratio. Socioeconomic status was evaluated according to Graffar´s scale. HRQoL was ascertained using the SF-36. Disease activity was ascertained using the DAS28CRP and disease damage with the Sharp van der Heidje score. Use of prednisone was recorded as current dose of prednisone. The association between HRQoL and LBM was evaluated using Pearson’s correlation. Subsequently, a linear regression model was performed to evaluate the association between the SF-36 subcategories and LBM, adjusted for age, socioeconomic status, rheumatoid factor, disease duration, disease damage, disease activity and use of prednisone.
Results: Two-hundred and thirty six patients were evaluated; their average (SD) age was 57.4 (12.8) years. Disease duration was 14.0 (10.4) years; almost all patients were mestizo. 204 (87.9%) were rheumatoid factor positive. DAS28CRP was 4.0 (1.2), the Sharp van der Heidje total score was 99.5 (80.9), the current dose of prednisone was 4.7 (3.2) mg/d. Percentage of subtotal LBM was 58.2 (5.9), percentage of trunk LBM was 60.7 (6.8) and of appendicular LBM was 53.4 (6.3); trunk to appendicular lean mass ratio was 1.4 (0.1). Physical component summary (PCS) was 38.5 (16.9) and mental component summary (MCS) was 45.3 (16.6). In the univariate analysis, trunk to appendicular lean mass ratio was associated with lower PCS (Rho: -0.18); MCS (Rho: -0.21), physical function (Rho: -0.12), general health (Rho: -0.14), vitality (Rho: -0.18), social functioning (Rho: -0.17), role emotional (Rho: -0.15) and mental health (Rho: -0.15). In the adjusted model trunk to appendicular lean mass ratio was associated with PCS (standardized β: -0.17), MCS (β: -0.18), physical function (β: -0.19), general health (β: -0.17), vitality (β: -0.19), social functioning and mental health (β: -0.16); p<0.05 in all analyses.
There was a negative association between trunk to appendicular lean mass ratio and the components of HRQoL independent of age, socioeconomic status, rheumatoid factor, disease activity, joint damage, disease duration and use of steroids in our RA patients. The preservation of LBM should be part of the overall goals in the management of RA patients.
R. V. Gamboa-Cardenas,
M. F. Ugarte-Gil,
J. M. Cucho-Venegas,
J. L. Alfaro-Lozano,
R. A. Perich-Campos,
K. E. Diaz-Deza,
C. A. Pastor-Asurza,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/lean-body-mass-lbm-distribution-negatively-impacts-on-health-related-quality-of-life-hrqol-in-patients-with-rheumatoid-arthritis-ra/