scholarly journals THU0358 NEGATIVE CHANGES OF BODY COMPOSITION IN MYOSITIS PATIENTS AND THEIR ASSOCIATION WITH DISEASE SPECIFIC CHARACTERISTICS, PHYSICAL ACTIVITY AND NUTRITIONAL STATUS.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 410.3-410
Author(s):  
S. Oreska ◽  
M. Špiritović ◽  
P. Česák ◽  
O. Marecek ◽  
H. Štorkánová ◽  
...  
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Body Composition ◽  
Lipid Metabolism ◽  
Nutritional Status ◽  
Disease Activity ◽  
Inflammatory Cytokines ◽  
Disease Duration ◽  
Serum Levels ◽  
Muscle 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

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

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

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

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

scholarly journals Serum Cytokine Profile in Asian Indian Patients with Takayasu Arteritis and its Association with Disease Activity

2017 ◽  
Vol 11 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Ruchika Goel ◽  
Jayakanthan Kabeerdoss ◽  
Babu Ram ◽  
John Antony Jude Prakash ◽  
Sudhir Babji ◽  
...  
Keyword(s):  
Disease Activity ◽  
Asian Indian ◽  
Inflammatory Cytokines ◽  
Stable Disease ◽  
Disease Duration ◽  
Serum Levels ◽  
Indian Patients ◽  
Ifn Γ ◽  
Active Disease

Background: Arterial inflammation Takayasu arteritis (TA) is an outcome of balance between pro- and anti-inflammatory cytokines. Comprehensive assessment of these cytokines is important for understanding pathogenesis and assessing disease activity. Objective: To study pro- and anti-inflammatory cytokines representing different T-helper cell pathway in serum samples of Asian Indian patients with TA and to assess their association with disease activity. Methods: Consecutive Indian patients with TA were assayed for serum interferon-γ, interleukin-6, interleukin-23, interleukin-17, interleukin-10 and transforming growth factor- β levels at baseline and follow up visit. Patients were grouped into active and stable disease based on Indian Takyasu Arteritis clinical Activity Score-2010. Serum levels of these cytokines between active and stable disease and between baseline and follow up visits were compared by non-parametric tests. Results: Among 32 patients enrolled, 15 were classified as active while 17 as stable disease at baseline. IFN-γ levels were significantly higher in active disease than stable disease (p=0.0129) while other cytokines did not differ significantly between 2 groups. Serum levels of none of the cytokines changed significantly over 2 visits in both responders and non-responders. IL23 levels positively correlate with disease duration ((r=0.999; p<0.005). Modest correlation was observed between IFN-γ and IL23 levels at both baseline and follow up and between IFN-γ and IL-6 and CRP at follow up. Conclusion: IFN-γ levels are raised in active disease in TA and correlates well with other biomarkers of disease activity and proinflammatory cytokines. There is also a direct correlation between Il-23 levels and disease duration.

scholarly journals SAT0047 RISK FACTORS FOR THE POSTOPERATIVE DELAYED WOUND HEALING IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH A BIOLOGICAL AGENT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 954.3-954
Author(s):  
S. Okita ◽  
H. Ishikawa ◽  
A. Abe ◽  
S. Ito ◽  
A. Murasawa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Wound Healing ◽  
Retrospective Study ◽  
Nutritional Status ◽  
Disease Activity ◽  
Disease Duration ◽  
Foot And Ankle ◽  
Delayed Wound Healing ◽  
Chugai Pharmaceutical

Background:It has been suggested that perioperative use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients carries risks for the surgical-site infection and the delayed wound healing (DWH); however, the risk of DWH with perioperative use of bDMARDs has not reached a general consensus.Objectives:This retrospective study aimed to investigate the risk factors associated with DWH after orthopedic surgery in RA patients treated with bDMARDs.Methods:We reviewed medical records of 277 orthopedic procedures for 188 RA patients treated with bDMARDs between from 2014 to 2017 in Niigata Rheumatic Center. As preoperative nutritional status assessment, we evaluated body mass index (BMI), prognostic nutritional index (PNI), and CONtrolling NUTritional status (CONUT). In addition, we evaluated DAS28-CRP, DAS28-ESR, face scale for pain, global health (GH), and Health Assessment Questionnaire-Disability Index (HAQ-DI) to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factor for DWH.Results:The major characteristics of the patients in 277 procedures were mean age of 63.2 years old and mean disease duration of 18.2 years. Surgical site were hand and wrist (145 procedures), foot and ankle (76), hip and knee (31), elbow and shoulder (24), and spine (1). Seventy-four patients were treated with tocilizumab, 62 with etanercept, 55 with golimumab, 49 with abatacept, 16 with infliximab, 15 with adalimumab, and 6 with certolizumab. According to nutritional assessment in PNI and CONUT, 63% (n=175) and 47% (n=130) were normal nourished patients, respectively.In 277 procedures, DWH were identified in 24 patients (8.6%). The following variables were significant in the univariate analyses: disease duration (OR 1.053; 95% CI 1.010–1.099; p=0.016), foot and ankle surgery (OR 7.091; 95% CI 2.130–23.603; p=0.001), tocilizumab (OR 0.286; 95% CI 0.093–0.881; p=0.029) (Table 1). These variables were entered into a multivariate model, and it was revealed that pre-operative use of tocilizumab (OR 0.265; 95% CI 0.074–0.953; p=0.042) and procedures in the foot and ankle (OR 6.915; 95% CI 1.914–24.976; p=0.003) were associated with an increased risk of DWH (Table 1).Conclusion:As previous study on tocilizumab described, the current retrospective study suggested that pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH. Pre-operative disease activity and nutritional status were not independent risk factors for an increase in the prevalence of DWH.References:[1] Momohara S, Hashimoto J, Tsuboi H et al. Analysis of perioperative clinical features and complications after orthopaedic surgery in rheumatoid arthritis patients treated with tocilizumab in a real-world setting: Results from the multicentre tocilizumab in perioperative period (TOPP) study. Modern rheumatology. 2013, 23: 440-9.Disclosure of Interests:Shunji Okita: None declared, Hajime Ishikawa: None declared, Asami Abe: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Akira Murasawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Toshifumi Ozaki: None declared

scholarly journals Dual X-ray absorptiometry whole body composition of adipose tissue in rheumatoid arthritis

2015 ◽  
Vol 53 (3) ◽  
pp. 237-247
Author(s):  
C. Popescu ◽  
Violeta Bojincă ◽  
Daniela Opriş ◽  
Ruxandra Ionescu
Keyword(s):  
Rheumatoid Arthritis ◽  
Physical Activity ◽  
Body Composition ◽  
Adipose Tissue ◽  
Disease Duration ◽  
Whole Body ◽  
Glucocorticoid Treatment ◽  
X Ray ◽  
Body Adiposity ◽  
Postmenopausal Female

Abstract Aim. Rheumatoid arthritis (RA) may influence not only abdominal fat, but also whole body adiposity, since it is associated with chronic inflammation and disability. The study aims to evaluate the whole body adiposity of RA patients and to assess potential influences of disease specific measures. Methods. The study was designed to include Caucasian postmenopausal female RA patients and age-matched postmenopausal female controls. Each subject underwent on the same day clinical examination, laboratory tests, whole body dual X-ray absorptiometry (DXA) composition and physical activity estimation using a self-administered questionnaire. Results. A total of 107 RA women and 104 matched controls were included. Compared to controls, the RA group had less physical activity and a higher prevalence of normal weight obesity. Overfat RA women had a significantly higher toll of inflammation, disease activity, glucocorticoid treatment and sedentary behavior. RA women with inflammation, glucocorticoid treatment and higher disease activity class had higher whole body and trunk adipose tissue indices and higher prevalence of overfat status. Glucocorticoid treatment, inflammation, disease duration and severity correlated with whole body adipose tissue and significantly predicted high adiposity content and overfat phenotypes. Conclusions. RA disease duration and severity are associated with higher whole body and regional adiposity. Low-dose glucocorticoid treatment seems to contribute to adiposity gain and redistribution. Clinicians may need to assess body composition and physical activity in RA patients in order to fully manage cardiovascular outcomes and quality of life.

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