FRI0243 SARCOPENIA IS ASSOCIATED WITH MALNUTRITION IN PATIENTS WITH SYSTEMIC SCLEROSIS
Authors: V. Hax, R. Cavalheiro Do Espírito Santo, E. Pena, L. Rodrigues, R. T. Pedo, J. Miranda de Souza Silva, N. Pamplona Bueno de Andrade, A. A. Gasparin, R. Xavier, R. Mendonça Da Silva Chakr
Journal: Annals of the Rheumatic Diseases (2020)

Background: Sarcopenia is one of the major health problems in older patients and is defined as a progressive decrease in muscle mass and function 1 . Sarcopenia has only rarely been studied in systemic sclerosis (SSc) and its impact in clinical characteristics of SSc is poorly investigated. Objectives: To evaluate the associations between sarcopenia and clinical features in SSc patients. Methods: Cross-sectional study, including 82 patients who met the ACR/EULAR 2013 classification criteria for SSc. Dual-energy X-ray absorptiometry, handgrip strength, and short physical performance battery were used to assess sarcopenia according the European Working Group on Sarcopenia in Older People’s (EWGSOP) diagnostic criteria updated in 2019 1 . Malnutrition was evaluated according to the European Society of Clinical Nutrition and Metabolism (ESPEN) 2 , using the Malnutrition Universal Screening Tool (MUST) to screen risk for malnutrition. Results: The mean age was 60.4 years and 91.5% were women (table 1). Sarcopenia was identified in 15 (18.3%) SSc patients. Malnutrition was diagnosed in 12 (14.6%) and was more common in patients with sarcopenia ( P= 0.038). Also, there were significant differences between patients with and without sarcopenia regarding Body Mass Index ( P =0.001), Fat Free Mass Index ( P &lt;0.001), knee extension strength ( P =0.049), and Timed Up and Go test ( P =0.041). There were no differences regarding age, disease duration, Rodnan skin score (mRSS), FVC and DLCO. Table 1. Clinical characteristics of SSc patients with and without sarcopenia. Data presented as number (%) of patients, except when indicated otherwise. Patients features Whole (n=82) SSc patients without sarcopenia (n=67) SSc patients with sarcopenia (n=15) P value Females 75 (91.5) 62 (92.5) 13 (86.6) 0.606 Caucasian 68 (82.9) 53 (79.1) 15 (100) 0.258 Age (years) b 60.4 (10.6) 60.2 (10.3) 61.5 (12.3) 0.678 Diffuse skin involvement 16 (19.5) 16 (23.8) 0 (0) 0.082 Disease duration (years) a 12.8 (7.5, 19.2) 12.7 (7.1,19.2) 13.4 (8.9, 19.8) 0.324 Rodnan skin score a 4.0 (2.0, 10.0) 5.0 (2.0, 10.0) 2.0 (2.0,10.0) 0.076 Interstitial lung disease on HRCT 32 (39.5) 25 (37.3) 7 (10.4) 0.737 FVC (% predicted) b 88.4 (16.6) 88.4 (16.9) 88.3 (15.3) 0.991 DLCO (% predicted) b 63.7 (11.9) 63.6 (12.2) 64.2 (11.2) 0.855 BMI (kg/m 2 ) b 25.6 (4.6) 26.5 (4.4) 21.8 (4.1) 0.001 FFMI (kg/m 2 ) b 15.6 (1.7) 16.1 (1.6) 13.8 (1.2) &lt;0.001 FMI (kg/m 2 ) b 9.5 (3.7) 9.9 (3.6) 7.5 (3.5) 0.023 Malnutrition 12 (14.6) 7 (10.4) 5 (33.3) 0.038 MUST - Low risk 58 (70.7) 51 (76.1) 7 (46.7) 0.046 Moderate and high risk 24 (29.3) 16 (23.9) 8 (53.3) HAQ b 0.778 (0.591) 0.797 (0.575) 0.833 (0.576) 0.825 Timed Up and Go test (s) a 8.41 (7.41, 10.59) 8.39 (7.5, 9.4) 10.23 (7, 14) 0.041 Knee extension strength (kgf) a 21.40 (15.65, 27.52) 21.70 (18.05, 28.35) 14.82 (9.5, 24) 0.049 a Median (25, 75 th percentiles) b Mean (standard deviation) Abbreviations: BMI: body mass Index; DLCO: diffusion capacity of carbon monoxide; FFMI: fat free mass index; FMI: fat mass index; FVC: forced vital capacity; HAQ: Health Assessment Questionnaire; HRCT: high-resolution computed tomography; MUST: Malnutrition Universal Screening Tool; SSc: systemic sclerosis. Conclusion: Sarcopenia is relatively common and is associated with malnutrition in patients with SSc. In our population, sarcopenia was not associated with other features related to a more severe disease. The role of sarcopenia in the prognosis of SSc needs to be better understood in longitudinal studies. References: [1]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. [2]Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015;34(3):335-40 Disclosure of Interests: Vanessa Hax: None declared, Rafaela Cavalheiro do Espírito Santo: None declared, Emerson Pena: None declared, Luísa Rodrigues: None declared, Renata Ternus Pedo: None declared, Jordana Miranda de Souza Silva: None declared, Nicole Pamplona Bueno de Andrade: None declared, Andrese Aline Gasparin: None declared, Ricardo Xavier Consultant of: AbbVie, Pfizer, Novartis, Janssen, Eli Lilly, Roche, Rafael Mendonça da Silva Chakr: None declared