AB0799 Alterations of body composition in scleroderma patients are associated with disease activity and physical activity but not with lung involvement

Background:Skeletal muscle, pulmonary and articular involvement in idiopathic inflammatory myopathies (IIM) limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition.Objectives:The aim was to assess body composition and physical activity of IIM patients and healthy controls (HC) and the association with selected inflammatory cytokines/chemokines and laboratory markers of nutrition and lipid metabolism.Methods:54 patients with IIM (45 females; mean age 57.7; disease duration 5.8 years; polymyositis (PM, 22) / dermatomyositis (DM, 25) / necrotizing myopathy (IMNM, 7)) and 54 age-/sex-matched HC (45 females, mean age 57.7) without rheumatic/tumor diseases were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA2000-M), physical activity (Human Activity Profile, HAP questionnaire), serum levels of 27 cytokines/chemokines (commercial multiplex ELISA kit, Bio-Rad Laboratories) and serum levels of selected parameters of nutrition and lipidogram. Disease activity (MITAX and MYOACT activity score) and muscle involvement (manual muscle testing, MMT-8, and functional index 2, FI2) were evaluated. Data are presented as mean±SD.Results:Compared to HC, patients with IIM had a trend towards significantly increased body fat % (BF%; iDXA: 39.9±7.1 vs. 42.4±7.1 %, p=0.077), but significantly decreased lean body mass (LBM; iDXA: 45.6±8.1 vs. 40.6±7.2 kg, p=0.001; BIA: 52.6±8.8 vs. 48.7±9.0 kg, p=0.023), increased extracellular mass/body cell mass (ECM/BCM) ratio (1.06±0.15 vs. 1.44±0.42, p<0.001), reflecting deteriorated nutritional status and predisposition for physical activity, and significantly lower bone mineral density (BMD: 1.2±0.1 vs. 1.1±0.1 g/cm2, p<0.001). Disease duration negatively correlated with BMD and LBM-BIA. Disease activity (MITAX, MYOACT) positively correlated with LBM (by BIA and DXA), similarly as with basal metabolic rate (BMR), and fat free mass (FFM). CRP was positively associated with BF% (BIA and DXA). Higher BF%-DEXA was associated with worse physical endurance (FI2) and worse ability to perform physical activity (HAP). MMT-8 score negatively correlated with ECM/BCM ratio. Serum levels of several inflammatory cytokines/chemokines (specifically IL-1ra, MCP, IL-10) and markers of nutrition (specifically albumin, C3-, C4-complement, cholinesterase, amylase, insulin and C-peptide, vitamin-D, orosomucoid), and lipid metabolism (specifically triglycerides, high-density lipoprotein, apolipoprotein A and B, atherogenic index of plasma) were significantly associated with alterations of body composition in IIM patients. (p<0.05 for all correlations)Conclusion:Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients associated with their disease activity and duration, inflammatory status, skeletal muscle involvement, and physical activity. These data could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance.Serum levels of certain inflammatory cytokines/chemokines and markers of nutrition and lipid metabolism were associated with alterations of body composition in IIM patients. This might further support the role of systemic inflammation and nutritional status on the negative changes in body composition of IIM patients.Acknowledgments:Supported by AZV NV18-01-00161A, MHCR 023728, SVV 260373 and GAUK 312218Disclosure of Interests:Sabina Oreska: None declared, Maja Špiritović: None declared, Petr Česák: None declared, Ondrej Marecek: None declared, Hana Štorkánová: None declared, Barbora Heřmánková: None declared, Kateřina Kubinova: None declared, Martin Klein: None declared, Lucia Vernerová: None declared, Olga Růžičková: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Heřman Mann: None declared, Jiří Vencovský: None declared, Michal Tomčík: None declared

Download Full-text

P167 Association of changes of body composition in scleroderma patients with disease activity, physical activity and serum levels of inflammatory cytokines

10.1136/annrheumdis-2018-ewrr2019.149 ◽

2019 ◽

Author(s):

S Oreska ◽

M Spiritovic ◽

P Cesak ◽

M Cesak ◽

H Storkanova ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Disease Activity ◽

Inflammatory Cytokines ◽

Serum Levels

Download Full-text

AB0548 ASSESMENT OF THE PHYSICAL ACTIVITY IN SYSTEMIC SCLEROSIS PATIENTS BY USING COMMERCIAL SMART BANDS AND ITS ASSOCIATION WITH DISEASE CHARACTERISTICS: A PILOT STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4641 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1571.1-1571

Author(s):

A. Avanoğlu Güler ◽

H. Karadeniz ◽

R. Bilici Salman ◽

H. Satiş ◽

H. Babaoglu ◽

...

Keyword(s):

Physical Activity ◽

Heart Rate ◽

Pulmonary Function ◽

Disease Activity ◽

Pulmonary Function Tests ◽

Lung Involvement ◽

Step Counts ◽

Function Tests ◽

Patient Reported ◽

Pulmonary Arterial

Background:Systemic sclerosis (SSc) is a complex disease, characterized by multi-system organ involvement including interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). The decrease in physical activity in SSc patients with lung involvement has been demonstrated by self-reported physical capacity and 6 min-walking test (6MWT) (1, 2). Commercial smart bands can provide data on daily physical activity, sleep characteristics, blood oxygen concentration and heart rate measurement, therefore may aid in monitoring disease activity.Objectives:The aim of this study is to evaluate physical activity in SSc patients by using a commercial smart band and investigate its association with clinical characteristics and patient-reported outcome measures of disease activityMethods:This prospective observational study included SSc patients with having a smartphone. Patients characteristics including age, sex, and organ involvements were recorded. Each participant was subjected to pulmonary function tests and 6MWT. All of patients answered Scleroderma Health Assessment Questionnaire (SHAQ, consisting of HAQ-Disability Index (DI) and visual analog scales (VAS) domains). All patients received Fitbit inspire HR smart band® which records the number of steps, heart rate, distance and was instructed to wear it continuously for one week. Tracked data was collected from smartphones via Fitbit application.Results:Fifteen SSc patients (14 females and 1 male) participated in the study, 8 (53.3%) had limited SSc and 7 (46.7) had diffuse SSc. The mean age was 48.5±15.5 and the median disease duration was 4 (min-max:1-9) years. Eleven (73.3%) patients had ILD and one patient had PAH. Musculoskeletal complaints were evident in two patients. Forced vital capacity (FVC, % predicted), diffusion capacity of lung for carbon monoxide (DLCO, %) in patients with ILD were significantly lower than patients without ILD median (IQR) 102 (30) vs 80 (27) p= 0.026, 57 (20) vs 95 (13), p= 0.002, respectively. The median distance of 6MWTs were 450 (225) vs 568 (102) in ILD and non-ILD groups. The median total weekly step counts of ILD patients were remarkably lower in ILD patients compared to non-ILD 36.137 (17.879) vs 58.114 (80.681) steps/week, (p= 0.01). Patients with ILD had a bit higher median heart rate compared to non-ILD, 73 (9) vs 67.5 (12). The total weekly step counts were correlated with pulmonary function tests, including forced expiratory volume in one second (FEV1%) (r= 0.57, p= 0.025), FVC (%) (r= 0.65, p= 0.009), and DLCO (%) (r= 0.70, p= 0.005), patient-reported disease severity (r=-0.66, p= 0.007), and breathing problem (r= -0.55, p= 0.03) domains of SHAQ. There was no correlation between weekly step counts and 6MWTConclusion:The assessment of physical activity with smart activity bands may help to identify SSc patients with ILD. Tracked physical activity using smart bands correlates with pulmonary function tests and performs better than 6MWT, suggesting it as a useful tool for the assessment of disease activity.References:[1]Battaglia S, Bellia M, Serafino-Agrusa L, Giardina A, Messina M, Cannizzaro F, et al. Physical capacity in performing daily activities is reduced in scleroderma patients with early lung involvement.Clin Respir J(2017) 11(1):36-42.[2]Mainguy V, Provencher S, Maltais F, Malenfant S, Saey D. Assessment of daily life physical activities in pulmonary arterial hypertension.PLoS One(2011) 6(11):e27993.Disclosure of Interests:None declared

Download Full-text

SAT0110 SARCOPENIA IN PATIENTS WITH RHEUMATOID ARTHRITIS ON THE TREATMENT WITH BIOLOGIC DISEASE MODIFYING ANTI-RHEUMATIC DRUGS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1036 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 989.1-989

Author(s):

E. Hasegawa ◽

S. Ito ◽

Y. Kurosawa ◽

S. Taniguchi ◽

D. Kobayashi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Skeletal Muscle ◽

Body Composition ◽

Nutritional Status ◽

Disease Activity ◽

Muscle Mass ◽

Nutrition Status ◽

Physical Ability ◽

Disease Modifying

Background:Sarcopenia is characterized by loss of muscle mass and strength, which lead to lower physical ability, less quality of life (QoL), frailty and mortality. Rheumatoid arthritis (RA) is considered to be one of the causes of sarcopenia.Objectives:To clarify the effectiveness of biologic disease modifying anti-rheumatic drugs (bDMARDs) on sarcopenia, including physical ability, body composition and nutritional status.Methods:This is a prospective cohort study including consecutive 48 patients (male 11, female 37, age 64.2±15.1) with RA who started bDMARDs in Niigata Rheumatic Center. Diagnosis of sarcopenia was according to the diagnostic algorithm of European Working Group on Sarcopenia in Older People (EWGSOP). We monitored disease activity of RA, physical ability, body composition, nutritional status and QoL at baseline, 6 months and at 12 months. Disease activity was measured by disease activity score-28 joint count based on erythrocyte sedimentation rate (DAS28-ESR), clinical disease activity index (CDAI). Physical activity was measured by Health Assessment Questionnaire (HAQ), 10m walking test (10MWT). Nutritional status was measured by controlling nutrition status (CONUT) score, and prognostic nutritional index (PNI). Overall QoL was measured by EuroQol 5 dimentions (EQ5D).Results:Among 48 patients who started bDMARDs, 21 patients were classified as having sarcopenia. The bDMARDs used were adalimumab in 10 cases, certolizumab pegol in 9 cases, abatacept in 9 cases, golimumab in 7 cases, tocilizumab in 5 cases, infliximab in 5 cases and etanercept in 3 cases. DAS28-ESR (4.7±1.4 vs. 2.7±1.0, p < 0.001) and CDAI (18.4±9.4 vs. 7.4±5.5, p<0.001) were significantly decreased by 12 months of bDMARDs therapy. Physical activity was significantly ameliorated after 12 months of bDMARDs; HAQ(1.1±0.9 vs. 0.6±0.8, p<0.001), 10MWT(1.5±0.7 m/s vs. 1.7±0.6, p=0.002). EQ-5D was also ameliorated(0.63±0.15 vs. 0.74±0.19, p=0.0002). As for body composition analysis, there were significant increase in body weight(54.6±12.4 kg vs. 55.8±13.6, p=0.006), but there was no significant increase in skeletal muscle mass index(5.9±1.1 kg/m2 vs. 5.9±1.1, p=0.229). Among 21 patients who were classified as sarcopenia when starting bDMARDs, the number of patients having sarcopenia significantly decreased after 12 months of bDMARDs (100% vs. 52.3%, p=0.0005) and skeletal muscle index of these patients were significantly increased (5.1±0.5 kg/m2 vs. 5.3±0.7, p=0.046).Conclusion:Twelve months of bDMARDs therapy significantly ameliorated disease activity, nutritional status and physical activity. In RA patients with sarcopenia, bDMARDs significantly increased skeletal muscle and may be effective for treatment of sacrcopenia.Disclosure of Interests: :Eriko Hasegawa: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Yoichi Kurosawa: None declared, Shinji Taniguchi: None declared, Daisuke Kobayashi: None declared, Asami Abe: None declared, Hiroshi Otani: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared

Download Full-text

FRI0255 BODY COMPOSITION IN SCLERODERMA PATIENTS IS ASSOCIATED WITH DISEASE ACTIVITY, SERUM LEVELS OF INFLAMMATORY CYTOKINES AND PARAMETERS OF NUTRITION AND LIPID METABOLISM

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6214 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 711.3-712

Author(s):

S. Oreska ◽

M. Špiritović ◽

P. Česák ◽

M. Cesak ◽

H. Štorkánová ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Lipid Metabolism ◽

Nutritional Status ◽

Disease Activity ◽

Body Mass ◽

Inflammatory Cytokines ◽

Serum Levels ◽

Atherogenic Index ◽

Musculoskeletal Involvement

Background:Fibrosis of the skin and visceral organs, especially digestive tract, and musculoskeletal involvement in systemic sclerosis (SSc) can have a negative impact on body composition, physical activity and nutritional status.Objectives:The aim was to assess body composition and physical activity of SSc patients and healthy controls (HC) and the association with selected inflammatory cytokines/chemokines and laboratory markers of nutritional status and lipid metabolism in SSc.Methods:59 patients with SSc (50 females; mean age 52.5; disease duration 6.7 years; lcSSc: 34/dcSSc: 25) and 59 age-/sex-matched HC (50 females, mean age 52.5) without rheumatic or tumour diseases were included. SSc patients fulfilled ACR/EULAR 2013 criteria. We assessed body composition (densitometry: iDXA Lunar, bioelectric impedance: BIA-2000-M), physical activity (Human Activity Profile, HAP questionnaire), disease activity (ESSG activity index), serum levels of 27 cytokines/chemokines (commercial multiplex ELISA kit, Bio-Rad Laboratories) and serum levels of chosen parameters of nutrition and lipidogram. Data are presented as mean±SD.Results:Compared to HC, patients with SSc had significantly lower body mass index (BMI, 27.4±8.3 vs. 22.4±4.3 kg/m2, p<0,001), body fat % (BF%, iDXA: 38.0±7.6 vs. 32.6±8.2 kg, p<0,001; BIA: 31.3±7.6 vs. 24.3±7.9 kg, p<0,001) and visceral fat weight (VF, 1.0±0.8 vs. 0.5±0.5 kg, p=0,001), and also significantly decreased lean body mass (LBM, iDXA: 51.9±8.4 vs. 47.8±7.0 kg, p=0,005; BIA: 45.4±7.3 vs. 40.9±6.8 kg, p=0,005), and bone mineral density (BMD, 1.2±0.1 vs. 1.0±0.1 g/cm2, p<0,001). Compared to HC, patients with SSc had increased extracellular mass/body cell mass (ECM/BCM, 1.03±0.1 vs. 1.28±0.4, p<0,001) ratio, reflecting deteriorated nutritional status and worse muscle predispositions for physical activity. Increased ECM/BCM in SSc was associated with higher disease activity (ESSG), increased skin score (mRSS) and inflammation (CRP, ESR), and with worse quality of life (HAQ, SHAQ), fatigue (FSS), and decreased physical activity (HAP). ESSG negatively correlated with BF%. HAP positively correlated with BMD. Serum levels of several inflammatory cytokines/chemokines (specifically IL-1b, IL-5, IL-6, IL-8, IL-17, TNF, Eotaxin) and markers of nutrition (specifically total protein, albumin, insulin and C-peptide) and lipid metabolism (specifically triglycerides, high-density lipoprotein, apolipoprotein A, atherogenic index of plasma) were significantly associated with alterations of body composition in patients with SSc (p<0.05 for all correlations).Conclusion:Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our SSc patients, which are associated with the disease activity and physical activity, and could reflect their nutritional status, and gastrointestinal and musculoskeletal involvement. Detected alterations of body composition in SSc patients were significantly associated with serum levels of several inflammatory cytokines/chemokines and markers of nutrition and lipid metabolism, which might further support the role of systemic inflammation and nutritional status on the negative changes in body composition of SSc patientsAcknowledgments:Supported by AZV NV18-01-00161A, MHCR 023728, SVV 260373 and GAUK 312218Disclosure of Interests:Sabina Oreska: None declared, Maja Špiritović: None declared, Petr Česák: None declared, Michal Cesak: None declared, Hana Štorkánová: None declared, Hana Smucrova: None declared, Barbora Heřmánková: None declared, Olga Růžičková: None declared, Heřman Mann: None declared, Karel Pavelka Consultant of: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Speakers bureau: Abbvie, MSD, BMS, Egis, Roche, UCB, Medac, Pfizer, Biogen, Ladislav Šenolt: None declared, Jiří Vencovský: None declared, Radim Bečvář Consultant of: Actelion, Roche, Michal Tomčík: None declared

Download Full-text

Adiposity Is Related to Inflammatory Disease Activity in Juvenile Idiopathic Arthritis

Journal of Clinical Medicine ◽

10.3390/jcm10173949 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3949

Author(s):

Gisela Diaz-Cordovés Rego ◽

Esmeralda Núñez-Cuadros ◽

Natalia Mena-Vázquez ◽

Soledad Aguado Henche ◽

Rocío Galindo-Zavala ◽

...

Keyword(s):

Physical Activity ◽

Body Composition ◽

Juvenile Idiopathic Arthritis ◽

Disease Activity ◽

Fat Mass ◽

Inflammatory Activity ◽

Healthy Population ◽

Fatty Tissue ◽

Cross Sectional ◽

Factors Associated

Objective: To identify factors associated with the higher proportion of fatty tissue and overweight/obesity observed in patients with juvenile idiopathic arthritis (JIA). Patients and methods: We performed a cross-sectional study of 80 JIA patients aged 4–15 years with 80 age- and sex-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry. The 27-joint Juvenile Arthritis Disease Activity score (JADAS27) was calculated. Two multivariate models were constructed to identify factors associated with overweight/obesity and fat mass index (FMI). Results: No differences were found between cases and controls in body mass index (BMI) or body composition. However, compared with controls, patients with a high inflammatory activity (JADAS27 > 4.2 for oligoarticular JIA or >8.5 for polyarticular disease) had higher values for BMI (p = 0.006); total fat mass (p = 0.003); FMI (p = 0.001); and fat in the legs (p = 0.001), trunk (p = 0.001), and arms (p = 0.002). The factors associated with overweight/obesity in patients were the duration of therapy with biological drugs, measured in months (OR [95% CI] = 1.12 [1.02–1.04]; p = 0.037), and physical activity (OR [95% CI] = 0.214 [0.07–0.68]; p = 0.010), while the factors associated with FMI were age (β [95% CI] = 0.30 [0.17–1.41]; p = 0.014), JADAS27 (β [95% CI] = 0.45 [0.16–1.08]; p = 0.009), and physical activity (β [95% CI] = −0.22 [−5.76 to 0.29]; p = 0.031). Conclusion: Our study revealed no differences between JIA patients with well-controlled disease and low disability and the healthy population in BMI or body composition. Furthermore, the association observed between inflammatory activity and adiposity could be responsible for poorer clinical course.

Download Full-text