The frequency of sarcopenia and factors affecting appendicular muscle mass in patients with systemic sclerosis

Aim. To determine the frequency of sarcopenia (SP) and to identify factors associated with the muscle mass in women with systemic sclerosis (SSc).

Materials and methods. The study included 64 women with SSc aged 40–70 years. Questionnaires, clinical, instrumental, laboratory examinations and absorptiometry. Linear regression analysis was performed to identify factors associat ed with appendicular muscle mass (AMM).

Results. Probable SP was detected in 35 (54.7 %), and confirmed SP – 17 (26.5 %) women with SSc. The frequency of SP did not differ depending on the form of the disease. Univariate linear analysis revealed the relationship between the AMM and BMI, nutritional status; mid-upper arm, waist, hip and calf circumferences, skin Rodnan score, cumulative dose of glucocorticoids (GC) and BMD of the proximal hip. Multivariate linear analysis confirmed the presence of associations between the AMM index and BMI (b = 0.65; p <0.001), the Rodnan skin score (b = –0.19; p = 0.047), the cumulative dose of GC (b = –0.22; p = 0.021).

Conclusion. The study demonstrated that more than a quarter of patients with SSc had a confirmed SP. Although age is the main risk factor for SP in the general population, in our study it did not differ between patients with low and normal AMM. The cumulative dose of GC and the Rodnan skin score were negatively, and BMI was positively associated with the value of AMМ.

1. Guseva N.G. Sistemnaya sklerodermiya // Sigidin Ya. A, Guseva N.G., Ivanova M.M. Diffuznye bolezni soedinitel’noi tkani. Moscow: Meditsina; 2004. P. 341–57 (In Russ.).

2. Cutolo M., Soldano S., Smith V. Pathophysiology of systemic sclerosis: current understanding and new insights. Expert Rev Clin Immunol 2019; 15(7):753–64. DOI: 10.1080/1744666X.2019.1614915

3. Soldano S., Pizzorni C., Paolino S. et al. Alternatively activated (M2) macrophage phenotype is inducible by endothelin-1 in cultured human macrophages. PLoS ONE 2017;12(3):e0175238. DOI: 10.1371/journal.pone.0175238

4. Payne G.W., Bearden S.E. The microcirculation of skeletal muscle in aging. Microcirculation 2006;13(4):275–7. DOI: 10.1080/10739680600618710

5. Hendrickse P., Degens H. The role of the microcirculation in muscle function and plasticity. Muscle Res Cell Motil 2019;40(2):127–40. DOI: 10.1007/s10974-019-09520-2

6. Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48(1):16–31. DOI: 10.1093/ageing/afy169.

7. Santilli V., Bernetti A., Mangone M. et al. Clinical definition of sarcopenia. Clin Cases Miner Bone Metab 2014;11(3):177–80. PMID: 25568649.

8. Siegert E., March C., Otten L. et al. Prevalence of sarcopenia in systemic sclerosis: assessing body composition and functional disability in patients with systemic sclerosis. Nutrition 2018;55–56:51–5. DOI: 10.1016/j.nut.2018.03.046

9. Lavrishcheva I.V., Jakovenko A.A., Rumyantsev A.S. The prevalence of sarcopenia in patients with rheumatological pathology. Terapevticheskii arkhiv 2021;93(5):568–72. DOI: 10.26442/00403660.2021.05.200788 (In Russ.).

10. Caimmi C., Caramaschi P., Venturini A. et al. Malnutrition sarcopenia in a large cohort of patients with systemic sclerosis. Clin Rheumatol 2018;37(4):987–97. DOI: 10.1007/s10067-017-3932-y

11. Corallo C., Fioravanti A., Tenti S. et al. Sarcopenia in systemic sclerosis: the impact of nutritional, clinical, and laboratory features. Rheumatol Int 2019;39(10):1767–75. DOI: 10.1007/s00296-019-04401-w

12. Hax V., do Espírito Santo R.C., dos Santos L.P. et al. Practical screening tools for sarcopenia in patients with systemic sclerosis. PLoS One 2021;16(1):e0245683. DOI: 10.1371/journal.pone.0245683

13. Marighela T.F., Genaro P. de S., Pinheiro M.M. et al. Risk factors for body composition abnormalities in systemic sclerosis. Clin Rheumatol 2013;32(7): 1037–44. DOI: 10.1007/s10067-013-2235-1

14. Safonova Yu.A., Glazunova G.M. Kriterii diagnostiki i rasprostranennost’ sarkopenii u lyudei pozhilogo i starcheskogo vozrasta. Uspekhi gerontologii. 2019;32(6):882–8 (In Russ.).

15. Wang C., Bai L. Sarcopenia in the elderly: basic and clinical issues. Geriatr Gerontol Int 2012;12(3):388–96. DOI: 10.1111/j. 1447-0594.2012.00851.x

16. Leavens A., Patten S.B., Hudson M. et al. Canadian Scleroderma Research Group. Influence of somatic symptoms on Patient Health Questionnaire-9 depression scores among patients with systemic sclerosis compared to a healthy general population sample. Arthritis Care Res (Hoboken) 2012;64(8):1195–201. DOI: 10.1002/acr.21675

17. Muangchan C., Harding S., Khimdas S. et al. Association of C-reactive protein with high disease activity in systemic sclerosis: results from the Canadian Scleroderma Research Group. Arthritis Care Res (Hoboken) 2012;64(9): 1405–14. DOI: 10.1002/acr.21716