FRI0052 BODY COMPOSITION IN MEN WITH RHEUMATOID ARTHRITIS
Authors: Artem Kondrashov, Nadezhda Shostak, Anaida Muradyants
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Rheumatoid arthritis (RA) is a chronic immune inflammation of the joints, leading to early disability of patients at high risk of cardiovascular events and osteoporotic fractures. This problem is important today in men with RA, because, due to more frequent severe disease and increased mortality in the year after the fracture. Reduction of bone mineral density (BMD) and muscle mass are significant predictors of fractures, which leads to the high importance of studying the state of BMD and body composition. <h3>Objectives</h3> Improving the diagnosis of osteoporosis in patients with RA of the male gender with the regard of BMD and body composition. <h3>Methods</h3> The study involved 110 male patients with a documented diagnosis of RA at the age of 59 [53; 65] years. Depending on the taking of glucocorticosteroids (GCS) all patients was allocated two groups: I subgroup - 60 patients who are not taking GCS and subgroup II - 50 patients who are taking GCS. The control group consisted of 30 healthy men comparable by the age and body mass index. The study of BMD at the lumbar spine (L1-L4) and femoral bone was measured by dual-energy x-ray absorptiometry using a bone mineral density «STRATOS dR» (DMS, France). Assessment of body composition was carried out, using the «Whole body» («The whole body»). Sarcopenia was diagnosided as a decrease in lean mass index of less than 7,26 kg/m<sup>2</sup>. <h3>Results</h3> 63,6% of patients with RA showed a reduction of BMD corresponding osteopenia/OP. OP was diagnosed in 28 (25,5%) patients with RA, and osteopenia - in 42 (38,2%). The detection rate of OP in the second subgroup was significantly higher (p&lt;0,05), than in the first subgroup (48% and 5% respectively). The most significant decrease in BMD was observed in the neck of the femur in the main group as a whole and in individual subgroups. There was a negative correlation degree of activity of RA and indicators of BMD of the lumbar spine (r=-0,4, p&lt;0,05) and proximal femur (r=-0,38, p&lt;0,05). Assessment of body composition showed that patients of the main group were significant decrease in the total lean mass (LM) of the body, and the trunk and limbs of LM compared with patients of the control group (p&lt;0,05). Sarcopenia detected in 66 (60%) of RA patients, whereas in the control group it was absent. In 44 (66,7%) male patients with RA with sarcopenia decreased BMD to the level of osteopenia (34,9%) and OP (31,8%). Obtained a negative correlation parameters LM and absolute 10 years risk of osteoporotic fractures (r=-0,302, p&lt;0,05) on FRAX. <h3>Conclusion</h3> 63,6% of men suffering from RA, there was a decrease in BMD, the corresponding OP/osteopenia with a primary reduction of BMD at the femoral neck. Decrease BMD in patients with RA was significantly associated with a high degree of disease activity (r=-0,4, p&lt; 0,05). Taking GCS had no significant effect on BMD at the femoral neck. Analysis of body composition in 55% of patients with RA showed a reduction in the level of LM limbs sarcopenia. Obtained correlation lower BMD and LM limbs (p&lt;0,05; r=0,28). Thus, in patients with RA male along with OP/osteopenia showed a significant decrease in LM that given the biomechanics of movement can be an additional risk factor for falls and fractures. <h3>References</h3> [1] Roux, C. (2011). Osteoporosis in inflammatory joint diseases.Osteoporosis International, 22(2), 421-433. [2] Giles, J. T., Bartlett, S. J., Andersen, et al. (2008). Association of body composition with disability in rheumatoid arthritis: impact of appendicular fat and lean tissue mass. Arthritis Care &amp; Research: Official Journal of the American College of Rheumatology, 59(10), 1407-1415. [3] Giusti, A., &amp; Bianchi, G. (2014). Male osteoporosis. Reumatismo,66(2), 136-143. [4] Thomas, D. R. (2007). Loss of skeletal muscle mass in aging: examining the relationship of starvation, sarcopenia and cachexia.Clinical nutrition, 26(4), 389-399. <h3>Disclosure of Interests</h3> None declared