scholarly journals POS0876 SARCOPENIA IN MYOSITIS PATIENTS: A MARKER OF MUSCLE DAMAGE ASSOCIATED WITH HANDICAP

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 694.1-694
Author(s):  
M. Giannini ◽  
A. L. Charles ◽  
M. Pizzimenti ◽  
L. Debrut ◽  
D. A. Levy ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Muscle Damage ◽  
Muscle Mass ◽  
Disease Duration ◽  
Health Assessment ◽  
Muscle Performance ◽  
Relevant Parameter ◽  
Immune Mediated ◽  
6Mwt Distance ◽  
6 Minute Walk Test

Background:Myositis are systemic autoimmune rare diseases characterized by muscle inflammation and weakness. Even though the signs of active disease have been resolved, myositis patients frequently present residual muscle weakness, decreased physical performance and sustained disability. This condition has been coined on the term “damage” (as opposed to “activity”).Sarcopenia is a frequent, progressive and generalized skeletal muscle disorder characterized by low muscle strength and mass leading to handicap, decreased quality of life and increased mortality.1Prevalence and significance of sarcopenia in myositis patients has never been reported.Objectives:To study sarcopenia in myositis patients with low or no disease activity.Methods:Adult myositis patients (2017 ACR/EULAR criteria), with disease duration greater than 12 months, creatine kinase serum level (CK) less than 500 U/l, stable medication for 6 months were enrolled. Patients with inclusion body myositis were excluded. Total (LM) and appendicular (ALM) muscle mass were measured using dual-energy X-ray absorptiometry (DXA, Hologic) and muscle grip strength was measured using Jamar dynamometer. Sarcopenia was defined according to the EWGSOP2 consensus.1Results:29 patients (20 female, 68.9%), with a median age of 61 years (50.5-71) were enrolled. They suffered from dermatomyositis (DM, n=4), immune-mediated necrotizing myopathy (IMNM), n=8), anti-synthetase syndrome (ASS, n=9), scleromyositis (SM, n=8) since 4.7 years (2.8-8.3). At the evaluation, muscle strength assessed with MMT-8 was 139/150 (136-147), MMT-12 was 210/220 (204-216) and CK were 131.5 U/l (105.5-202). Four patients (13.8%) were sarcopenic. Sarcopenic patients were older (73.4 years (66.2-80.5) vs 58.7 years (44.2-79.6), p=0.03), with a longer disease duration (7.3 years (5.3-11.8) vs 4.3 (2.7-8.3), p = 0.1), longer time with increased CK (449 days (169.8-954) vs 255.5 (124-872.8)), higher maximum CK values (6000 U/l (2205-7000) vs 1636 (900-4457)). They suffered from IMNM (2/4, 50%); DM (n=1) and SM (n=1), had more frequently disease-related cardiac involvement (50% vs 4%, p=0.04), and tended to a longer steroid therapy duration (2.4 years (0.8-5) vs 1.8 (1.3-3.9), p=0.9) and a higher number of immunomodulatory drugs (2.5 (2-5.3) vs 2 (2-3), p=0.3).At the evaluation, sarcopenic patients were globally weaker as highlighted by lower MMT-12 (201 (196.8-206.8) vs 213 (207-217.5), p=0.02). Head flexo-extensors and proximal upper muscles were especially weaker (respectively, p=0.04 and p=0.03). Muscle performance was also lower in sarcopenic patients as assessed by distance covered at 6-minute walk test (6mWT, p=0.003) and number of squats in 30 seconds (p=0.005). Time to drink a glass of water was significantly longer in sarcopenics (p=0.04) even if any patient referred dysphagia. Health assessment questionnaire score was greater (1.4 (0.8-2) vs 0.6 (0.2-1), p=0.04) indicating higher handicap. LM positively correlated with MMT-8 (ρ=0.5, p=0.01) and MMT-12 (ρ=0.5, p=0.004), with number of squats in 30 seconds (ρ=0.7, p=0.0003) and 6mWT distance covered/lower limit (ρ= 0.5, p=0.01). Moreover, LM negatively correlated with time to drink a glass of water (ρ=-0.6, p=0.002).Conclusion:Muscle mass measured by DXA is a relevant parameter for muscle damage and disability in myositis patients. Sarcopenic myositis patients represent a subgroup with important muscle damage and handicap.References:[1]Cruz-Jentoft AJ et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 1 Jan 2019;48(1):16-31.Disclosure of Interests:None declared

scholarly journals Diagnosis of sarcopenia in primary health care

2020 ◽  
Vol 63 (10) ◽  
pp. 633-641
Author(s):  
Chang Won Won
Keyword(s):  
Primary Care ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Handgrip Strength ◽  
Muscle Performance ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test ◽  
Primary Care Settings ◽  
Increased Risk

With aging, there is a loss of skeletal muscle mass and function, which leads to an increased risk of falls, fractures, long-term institutional care, cardiovascular and metabolic diseases, and even mortality. Sarcopenia has been defined as a condition characterized by low muscle mass together with low muscle strength and/or low muscle performance. In 2019, the Asian Working Group for Sarcopenia (AWGS) published a consensus paper on the diagnosis and treatment of sarcopenia. The AWGS 2019 guideline, in particular, presented strategies for case-finding and assessment, which could aid in the diagnosis of possible sarcopenia in primary care settings. AWGS 2019 proposed an algorithm that recommends calf circumference measurement (cut-off <34 cm in men, <33 cm in women) or the SARC-F (strength, assistance in walking, rising from a chair, climbing stairs, falls) questionnaire (cut-off ≥4), followed by handgrip strength measurement (cut-off <28 kg in men, <18 kg in women) or the 5-time chair stand test (≥12 seconds). Finally, “possible sarcopenia” is defined by either low muscle strength (handgrip strength) or low physical performance (5-time chair stand test). This paper will address the way in which sarcopenic patients can be identified and assessed practically in primary care settings.

scholarly journals Sarcopenia and Liver Cirrhosis—Comparison of the European Working Group on Sarcopenia Criteria 2010 and 2019

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 547 ◽  
Author(s):  
Julia Traub ◽  
Ina Bergheim ◽  
Martin Eibisberger ◽  
Vanessa Stadlbauer
Keyword(s):  
Liver Cirrhosis ◽  
Muscle Strength ◽  
Diagnostic Criteria ◽  
Muscle Mass ◽  
Working Group ◽  
Handgrip Strength ◽  
Muscle Performance ◽  
European Working Group ◽  
European Working ◽  
High Risk Populations

The European Working group on Sarcopenia in Older People recently updated the diagnostic criteria for sarcopenia. It is yet unclear how these modified criteria influence the rate of diagnosis in high risk populations, such as liver cirrhosis. We therefore assessed if the new diagnostic criteria for sarcopenia impacts on sarcopenia prevalence in liver cirrhosis. Within two years 114 cirrhotic patients were prospectively enrolled in the study. Sarcopenia was determined by muscle strength (handgrip strength), muscle mass (lumbal muscle index) and muscle performance (gait speed). Using the 2019 definition, the rate of pre-sarcopenia was significantly lower (30.7% versus 3.5%) due to the different starting points (2010 muscle mass, 2019 muscle strength) and cut-off values (muscle strength). The change in diagnostic criteria for sarcopenia drastically influences the rate of pre-sarcopenia diagnosis in cirrhotics. To evaluate, which diagnostic criteria should be chosen to diagnose sarcopenia in liver cirrhosis patients, prospective studies are needed.

scholarly journals The Effect of ACTN3 and VDR Polymorphisms on Skeletal Muscle Performance in Axial Spondyloarthropathies

2021 ◽  
Vol 12 ◽  
Author(s):  
Isabel Pimenta ◽  
Hugo Mateus ◽  
Santiago Rodrigues-Manica ◽  
Rita Pinheiro-Torres ◽  
Agna Neto ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Physical Properties ◽  
Muscle Mass ◽  
Muscle Performance ◽  
Inflammatory Rheumatic Diseases ◽  
Common Symptom ◽  
Muscle Properties ◽  
Control Approach ◽  
Common Group ◽  
And Performance

BackgroundSpondyloarthritis (SpA) are the most common group of chronic inflammatory rheumatic diseases affecting about 1.5% of the adult Caucasian population. Low back pain is the most common symptom. The aetiopathogenesis of SpA is multifactorial, with well-known genetic and environmental contributions. Furthermore, muscle properties might also be involved in the pathophysiological process and these could be modulated by the genetic background. Alpha-actinin-3 (ACTN3) and Vitamin D receptor (VDR) genes are well-known genes related with muscle performance. Our aim was to analyze four SNPs of these genes and to evaluate their influence in axial SpA (axSpA) susceptibility, phenotype and muscle properties.MethodsWe performed a pilot study based on case-control approach involving 56 participants: 28 axSpA patients and 28 healthy controls matched by age, gender and levels of physical activity. Clinical, epidemiological and muscle characterization data—muscle physical properties (stiffness, tone, and elasticity), strength, mass, and performance, were collected. Two different muscles were considered for analysis, the Multifidus and Gastrocnemius. Four SNPs of ACTN3 (rs1815739) and VDR (rs2228570, rs731236, and rs7975232), were selected, analyzed and correlated with clinical, epidemiological and muscle characterization data.ResultsIn total, 51 individuals (27 axSpA patients and 24 matched controls) were eligible for further genetic analysis, 66.7% being male and with a mean age of 36 years. Muscle physical properties, muscle strength and muscle mass were similar in both groups; however, axSpA patients showed a decrease in muscle performance. None of the studied SNPs were associated with disease susceptibility/phenotype, muscle physical properties, muscle strength or muscle mass. However, ACTN3 rs1815739 and VDR rs2228570 were shown to be associated with muscle performance.ConclusionOur results suggest an association between ACTN3 and VDR polymorphisms and muscle performance in axSpA.

Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure

2020 ◽  
Vol 28 (3) ◽  
pp. 290-299
Author(s):  
Kira A. Ageeva ◽  
Evgenii V. Filippov
Keyword(s):  
Respiratory System ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Walk Test ◽  
Ventricular Ejection Fraction ◽  
6Mwt Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

Sarcopenia is an actual problem in chronic kidney disease of the 5d stage

2020 ◽  
Vol 24 (1) ◽  
pp. 60-66
Author(s):  
I. V. Lavrishcheva ◽  
A. Sh. Rumyantsev ◽  
M. V. Zakharov ◽  
N. N. Kulaeva ◽  
V. M. Somova
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Mass ◽  
Chronic Kidney Disease Stage ◽  
Age Groups ◽  
Disease Stage ◽  
Actual Problem ◽  
European Working ◽  
Low Performance ◽  
6 Minute Walk Test

BACKGROUND. The lack of data on the epidemiology of presarcopenia/sarcopenia leads to an underestimation of the role of this condition in the structure of morbidity and mortality of haemodialysis patients in theRussian Federation. THE AIM: to study the epidemiological aspects of presarcopenia /sarcopenia in patients with chronic kidney disease stage 5d. PATIENTS AND METHODS. This study comprised 317 patients receiving programmed bicarbonate haemodialysis for 8.2 ± 5.1 years, among them 171 women and 146 men, the average age was 57.1 ± 11.3 years. The assessment of the presence of sarcopenia was performed using the method recommended by the European Working Group on Sarcopenia in Older People. RESULTS. The prevalence of presarcopenia was 0.7 % and sarcopenia 29.6 %. The incidence of skeletal muscle mass deficiency according to muscle mass index (IMM) was 30.3 %, 48.7 % showed a decrease in muscle strength according to dynamometry, and low performance of skeletal muscles according to 6 minute walk test was determined in 42.8 %. Sarcopenia patients were significantly characterized by lower body mass index, as well as higher body fat mass values. The duration of haemodialysis (χ2 = 22.376, p = 0.0001) and the patient's age (χ2 = 10.545 p = 0.014) were an independent risk factors for the development of sarcopenia. CONCLUSION. Sarcopenia is recorded more frequently in hemodialysis patients than presarcopenia. Its prevalence increases among patients of older age groups and with a hemodialysis duration of more than 5 years. The age and experience of dialysis make their independent contribution to the development of this syndrome.

scholarly journals Augmentation Index Is Inversely Associated with Skeletal Muscle Mass, Muscle Strength, and Anaerobic Power in Young Male Adults: A Preliminary Study

2021 ◽  
Vol 11 (7) ◽  
pp. 3146
Author(s):  
Dongmin Lee ◽  
Kyengho Byun ◽  
Moon-Hyon Hwang ◽  
Sewon Lee
Keyword(s):  
Skeletal Muscle ◽  
Muscle Strength ◽  
Arterial Stiffness ◽  
Muscle Mass ◽  
Muscular Strength ◽  
Skeletal Muscle Mass ◽  
Augmentation Index ◽  
Anaerobic Power ◽  
Negatively Associated ◽  
Increased Risk

Arterial stiffness is associated with an increased risk of cardiovascular disease. Previous studies have shown that there is a negative correlation between arterial stiffness and variables such as skeletal muscle mass, muscular strength, and anaerobic power in older individuals. However, little research has been undertaken on relationships in healthy young adults. This study presents a preliminary research that investigates the association between arterial stiffness and muscular factors in healthy male college students. Twenty-three healthy young males (23.9 ± 0.5 years) participated in the study. The participants visited the laboratory, and variables including body composition, blood pressure, arterial stiffness, blood parameters, grip strength, and anaerobic power were measured. Measurements of augmentation index (AIx) and brachial-ankle pulse wave velocity (baPWV) were performed to determine arterial stiffness. There were significant positive correlations among skeletal muscle mass, muscle strength, and anaerobic power in healthy young adult males. AIx was negatively associated with a skeletal muscle mass (r = −0.785, p < 0.01), muscular strength (r = −0.500, p < 0.05), and anaerobic power (r = −0.469, p < 0.05), respectively. Likewise, AIx@75 corrected with a heart rate of 75 was negatively associated with skeletal muscle mass (r = −0.738, p < 0.01), muscular strength (r = −0.461, p < 0.05), and anaerobic power (r = −0.420, p < 0.05) respectively. However, the baPWV showed no correlation with all muscular factors. Our findings suggest that maintaining high levels of skeletal muscle mass, muscular strength, and anaerobic power from relatively young age may lower AIx.

scholarly journals Respiratory Muscle Weakness as a Risk Factor for Pneumonia in Older People

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Tatsuma Okazaki ◽  
Yoshimi Suzukamo ◽  
Midori Miyatake ◽  
Riyo Komatsu ◽  
Masahiro Yaekashiwa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Muscle Strength ◽  
Older People ◽  
Serum Albumin ◽  
Muscle Mass ◽  
Muscle Weakness ◽  
Fat Mass ◽  
Respiratory Muscle ◽  
Respiratory Muscle Strength ◽  
Respiratory Muscle Weakness

Introduction: The respiratory muscle strength regulates the effectiveness of coughing, which clears the airways and protects people from pneumonia. Sarcopenia is an aging-related loss of muscle mass and function, the worsening of which is associated with malnutrition. The loss of respiratory and swallowing muscle strength occurs with aging, but its effect on pneumonia is unclear. This study aimed to determine the risks of respiratory muscle weakness on the onset and relapse of pneumonia in older people in conjunction with other muscle-related factors such as malnutrition. Methods: We conducted a longitudinal study with 47 pneumonia inpatients and 35 non-pneumonia controls aged 70 years and older. We evaluated the strength of respiratory and swallowing muscles, muscle mass, and malnutrition (assessed by serum albumin levels and somatic fat) during admission and confirmed pneumonia relapse within 6 months. The maximal inspiratory and expiratory pressures determined the respiratory muscle strength. Swallowing muscle strength was evaluated by tongue pressure. Bioelectrical impedance analysis was used to evaluate the muscle and fat mass. Results: The respiratory muscle strength, body trunk muscle mass, serum albumin level, somatic fat mass, and tongue pressure were significantly lower in pneumonia patients than in controls. Risk factors for the onset of pneumonia were low inspiratory respiratory muscle strength (odds ratio [OR], 6.85; 95% confidence interval [CI], 1.56–30.11), low body trunk muscle mass divided by height2 (OR, 6.86; 95% CI, 1.49–31.65), and low serum albumin level (OR, 5.46; 95% CI, 1.51–19.79). For the relapse of pneumonia, low somatic fat mass divided by height2 was a risk factor (OR, 20.10; 95% CI, 2.10–192.42). Discussion/Conclusions: Respiratory muscle weakness, lower body trunk muscle mass, and malnutrition were risk factors for the onset of pneumonia in older people. For the relapse of pneumonia, malnutrition was a risk factor.

Relationship between trunk muscle strength and trunk muscle mass and thickness using bioelectrical impedance analysis and ultrasound imaging

2021 ◽  
pp. 1-10
Author(s):  
Ryo Miyachi ◽  
Nana Koike ◽  
Suzu Kodama ◽  
Junya Miyazaki
Keyword(s):  
Muscle Strength ◽  
Muscle Mass ◽  
Ultrasound Imaging ◽  
Bioelectrical Impedance Analysis ◽  
Muscle Thickness ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Trunk Muscle ◽  
Trunk Muscles ◽  
Trunk Muscle Strength

BACKGROUND: Although trunk muscles are involved in many important functions, evaluating trunk muscle strength is not an easy task. If trunk muscle mass and thickness could be used as indicators of trunk muscle strength, the burden of measurement would be reduced, but the relationship between trunk muscle strength and trunk muscle mass and thickness has not been clarified. OBJECTIVE: The purpose of this study was to clarify the relationship between trunk muscle strength and trunk muscle mass by bioelectrical impedance analysis and trunk muscle thickness by ultrasound imaging in healthy adults. METHODS: One hundred and twenty-one healthy university students were included in this study. Trunk flexion/extension muscle strength and trunk muscle mass by bioelectrical impedance analysis, and trunk muscle thickness by ultrasound imaging were measured. RESULTS: Both trunk flexion strength and trunk extension strength were significantly correlated with trunk muscle mass and oblique and rectus abdominis muscle thickness. Multiple regression analysis showed that trunk extension muscle strength had an independent relationship with trunk muscle mass. CONCLUSIONS: This study demonstrated that trunk muscle mass or trunk muscle thickness can be used as an alternative means for evaluating trunk muscle strength, making the evaluation of trunk muscles less burdensome.

scholarly journals POS0574 RELATIONSHIP BETWEEN INVOLVED JOINT FOR REGION AND MODIFIED HEALTH ASSESSMENT QUESTIONNAIRE SCORE IN JAPANESE PATIENT WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 521.2-521
Author(s):  
I. Yoshii
Keyword(s):  
Health Assessment Questionnaire ◽  
Global Assessment ◽  
Disease Duration ◽  
Health Assessment ◽  
Lower Extremities ◽  
Upper Extremities ◽  
Whole Body ◽  
Large Joint ◽  
Small Joint ◽  
Assessment Questionnaire

Objectives:Rheumatoid arthritis (RA) is a chronic inflammatory disease that involves various joints in whole body. For evaluation of daily life activities (ADL), modified Health Assessment Questionnaire (mHAQ) is usually used. This index configures eight ADL functions these are separated by predominant extremities. This study aimed to evaluate how involved joint affect ADL predominantly in real world setting.Methods:A total of 24,450 times of consultation with RA patient were visited in the institute. Here, patient with RA was interviewed every another visit, and involved joint in whole body, pain score with visual analog scale (PS-VAS), and mHAQ were recorded. Involved joints were divided by four regions in accordance with joint size and part; small joint in upper extremities (US), large joint in upper extremities (UL), small joint in lower extremities (LS), and large joint in lower extremities (LL). mHAQ was also separately evaluated in accordance with predominant regions; upper extremities predominant mHAQ (mHAQ_UE), and lower extremities predominant mHAQ (mHAQ_LE). Adding to these parameters, as an index for disease activity monitoring, components of the simplified disease activity index score (SDAI) was also recorded. Relationship between mHAQ for each predominant extremities, and these parameters and sex, age, disease duration of RA, anti-cyclic citrullinated polypeptide antibodies (ACPA), rheumatoid factor (RF), and Sharp/van der Heijde score (SHS), were statistically evaluated using linear regression analysis.Results:mHAQ_UE significantly correlated with age, ACPA and RF titre, SHS, tenderness joint count (TJC), patient’s global assessment (PGA), evaluator’s global assessment (EGA), C-reactive protein (CRP), US, UL, LL, and PS-vas, whereas mHAQ-LE significantly correlated with all parameters that demonstrated significant correlation with mHAQ-UE and disease duration. mHAQ also correlated with all parameters those that demonstrated significant correlation with mHAQ-LE. Interestingly, all of mHAQ-UE, mHAQ-LE, and mHAQ did not correlated significantly with swollen joint count (SJC) and LS.Conclusion:mHAQ is influenced by various factors, however, SJC and involvement of small joint in lower extremities did not affect mHAQ.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document