FRI0349 RELATIONSHIPS BETWEEN BODY COMPOSITION AND NAILFOLD VIDEOCAPILLAROSCOPY PATTERNS IN SYSTEMIC SCLEROSIS PATIENTS
Authors: Veronica Tomatis, Sabrina Paolino, Alberto Sulli, Emanuele Gotelli, Andrea Casabella, Francesco Cattelan, Carlotta Schenone, Carmen Pizzorni, Elisa Alessandri, Maurizio Cutolo
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> 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). <h3>Objectives</h3> 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. <h3>Methods</h3> 38 patients (6 men and 32 women) fulfilling ACR 2013 criteria for SSc underwent NVC to assess their NVC patterns ("Early", "Active" and "Late" pattern)(4) and DXA to evaluate body composition(5). 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/m<sup>2</sup> for females and 7.25 Kg/m<sup>2</sup> for males(6). Statistical analysis was performed by non parametric tests. <h3>Results</h3> The mean age of patients was 64±11 years, mean disease duration 19.2 ±7.6 years, mean Rodnan skin score(mRSS) 11.5±9.3, and mean RSMI 6.3±1.05 g/cm<sup>2</sup>. All the patients showed a NVC "scleroderma pattern": in particular 15 patients showed the "Late<i>"</i> 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(58287±8217 <i>vs</i> 67238±11437 gr, p=0.01), lean mass(35249±3646 <i>vs</i> 41230±7954 gr, p= 0.05), RSMI(5.8±0.92 <i>vs</i> 6.6±1.02 g/cm<sup>2</sup>, p=0.02), BMC(1839±339 <i>vs</i> 2183±502 gr, p= 0.04), trunk BMD(0.70±0.12 <i>vs</i> 0.87±0.13 g/cm<sup>2</sup>, p=0.05) and spine BMD(0.91±0.17 <i>vs</i> 1.08±0.18 g/cm<sup>2</sup>, 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, 24% of SSc patients were found affected by sarcopenia, and the most of sarcopenic patients showed the "Late" NVC pattern(67%). 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). <h3>Conclusion</h3> 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, total lean mass, 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. <h3>Reference:</h3> [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.Haarbo J, et al. Clin Physiol 1991;11:331-41.6.Baumgartner RN, et al. Am J Epidemiol 1998;147:755-63. <h3>Disclosure of Interests</h3> None declared