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08.47 Decreased body fat, lean body mass and bone mineral density in scleroderma patients are associated with disease activity and physical activity
  1. Maja Spiritovic1,2,
  2. Sabina Oreska1,*,
  3. Petr Cesak2,
  4. Michal Cesak2,
  5. Hana Storkanova1,
  6. Katerina Kubinova1,
  7. Martin Klein1,
  8. Lucia Vernerova1,
  9. Olga Ruzickova1,
  10. Herman Mann1,
  11. Karel Pavelka1,
  12. Ladislav Senolt1,
  13. Jiri Vencovsky1,
  14. Radim Becvar1,
  15. Michal Tomcik1
  1. 1Institute of Rheumatology, Deartment of Rheumatology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, UK
  2. 2Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic, UK
  3. *The authors contributed equally

Abstract

Background Systemic sclerosis (SSc) is characterised by fibrosis of the skin and visceral organs, especially digestive tract, and musculoskeletal involvement, which limit mobility/self-sufficiency of patients, and can have a negative impact on body composition.

Objectives To assess body composition and physical activity of SSc patients and healthy controls (HC).

Methods 59 patients with SSc (50 females, 9 males; mean age 52.1; disease duration 6.7 years; limited cutaneous (lcSSc,36)/diffuse cutaneous (dcSSc,23)) and 36 age-/sex-matched HC (30 females, 6 males, mean age 51.4) without rheumatic/tumour diseases or manifest cardiovascular event were included. SSc patients fulfilled EULAR/ACR 2013 criteria. Anthropometric parameters and body composition were assessed (by densitometry-iDXA Lunar, and by bioelectric impedance-BIA-2000-M), and physical activity was evaluated using Human Activity Profile (HAP) questionnaire. Routine biochemistry analysis was performed after 8 hours of fasting. Disease activity was evaluated by EUSTAR SSc activity score. Data are presented as mean±SD.

Results Compared to HC, patients with SSc had significantly lower body-mass index (BMI: 26.4±3.3 vs. 22.4±4.3 kg/m2, p<0.0001) and body fat% assessed by both iDXA (BF%: 37.2±6.6 vs. 32.6%±8.2%, p=0.0014) and BIA (BF%: 31.1±6.4 vs. 24.6%±7.8%, p<0.0001), and a trend to decreased visceral fat weight (0.9±0.9 vs. 0.5±0.5 kg, p=0.0670). Compared to HC, SSc patients demonstrated significantly decreased lean body mass assessed by both iDXA (LBM: 46.6±7.5 vs. 40.9±6.8 kg, p=0.0003) and BIA (LBM: 53.2±8.7 vs. 47.7±7.0 kg, p=0.0017), and increased ECM/BCM ratio (extracellular mass/body cell mass: 1.03±0.1 vs. 1.29±0.4, p<0.0001), which reflects worse muscle predispositions for physical exercise, aerobic fitness/performance, and usually increases with deteriorating nutritional status. Compared to HC, SSc patients had significantly lower bone mineral density (BMD: 1.16±0.10 vs. 1.05±0.11g/cm2, p<0.0001), and were currently able to perform less energetically demanding physical activities according to HAP score (84.7±6.6 vs. 64.1±17.2, p<0.0001). Disease activity negatively correlated with BF% (r=−0.324, p=0.014), and physical activity (HAP) positively correlated with BMD (r=0.276, p=0.034) and negatively with ECM/BCM (r=−0.625, p<0.0001).

Conclusions Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our SSc patients, which are associated with their disease activity and physical activity, and could reflect their nutritional status, and gastrointestinal and musculoskeletal involvement.

Acknowledgement Supported by AZV-16–33574A.

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