Article Text

PDF
AB0671 Increased body fat but decreased lean body mass and bone mineral density in patients with idiopathic inflammatory myopathies are associated with disease duration, inflammatory status, skeletal muscle involvement and physical activity
  1. S Oreska1,
  2. M Spiritovic1,2,
  3. P Cesak2,
  4. O Marecek2,
  5. H Storkanova1,
  6. K Kubinova1,
  7. M Klein1,
  8. L Vernerova1,
  9. O Ruzickova1,
  10. R Becvar1,
  11. K Pavelka1,
  12. L Senolt1,
  13. H Mann1,
  14. J Vencovsky1,
  15. M Tomcik1
  1. 1Department of Rheumatology, 1st Medical Faculty, Charles University, Institute of Rheumatology
  2. 2Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic

Abstract

Background Idiopathic inflammatory myopathies (IIM) are characterized by inflammation and atrophy of skeletal muscles, pulmonary and articular involvement, which limit the mobility/self-sufficiency of patients, and can have a negative impact on body composition.

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

Methods 54 patients with IIM (45 females/9 males; mean age 57.3; disease duration 5.8 years; polymyositis (PM,22)/dermatomyositis (DM,25)/necrotizing myopathy (IMNM,7)) and 30 age-/sex-matched HC (25 females/5 males, mean age 54.9) without rheumatic/tumor diseases or manifest cardiovascular event were included. PM/DM patients fulfilled Bohan/Peter criteria for PM/DM. Anthropometric parameters and body composition were assessed (by densitometry-iDXA Lunar, and by bioelectric impedance-BIA2000-M), and physical activity was evaluated using Human Activity Profile (HAP) questionnaire. Routine biochemistry analysis was performed after 8 hours of fasting. Muscle involvement was evaluated by manual muscle test (MMT)-8. Data are presented as mean±SD.

Results Compared to HC, patients with IIM had significantly increased body fat % as assessed by iDXA (BF%: 38.7±6.7 vs. 42.5±7.1%, p=0.015), but decreased lean body mass as assessed both by iDXA (LBM: 45.7±6.6 vs. 40.3±7.0 kg, p=0.0005) and BIA (LBM: 53.2±8.5 vs. 48.7±9.0 kg, p=0.0295), and increased ECM/BCM ratio (extracellular mass/body cell mass: 1.00±0.12 vs. 1.43±0.42, p<0.0001), which reflects worse muscle predispositions for physical exercise, aerobic fitness/performance, and also increases with deteriorating nutritional status. Compared to HC, IIM patients had significantly lower bone mineral density (BMD: 1.16±0.10 vs. 1.05±0.11 g/cm2, p=0.0010), and were currently able to perform less energetically demanding physical activities according to HAP score (86.3±5.9 vs. 49.0±20.2, p<0.0001). Disease duration negatively correlated with BMD (r=-0.392, p=0.004) and LBM-BIA (r=-0.272, p=0.047). CRP was positively associated with BF% assessed both by DEXA (r=0.276, p=0.035) and BIA (r=0.306, p=0.025). MMT-8 score negatively correlated with ECM/BCM ratio (r=-0.385, p=0.006), and physical activity (HAP) negatively correlated with BF%>DEXA (r=-0.292, p=0.032).

Conclusions Compared to healthy age-/sex-matched individuals we found significant negative changes in body composition of our IIM patients, which are associated with their disease duration, inflammatory status, skeletal muscle involvement, and physical activity, and could reflect their impaired nutritional status and predispositions for physical exercise, aerobic fitness and performance.

Acknowledgements Supported by AZV-16–33574A, GAUK-214615.

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.