AB0373 Sarcopenia could not predict falls in patients with rheumatoid arthritis from the chikara study

• Published in: Annals of the rheumatic diseases Vol. 77; no. Suppl 2; p. 1356
• Main Authors: Tada, M., Yamada, Y., Mandai, K., Hidaka, N.
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2018
• Subjects: Body composition; Body mass index; Bone mass; Fractures; Health risk assessment; Matrix metalloproteinase; Metalloproteinase; Multivariate analysis; Musculoskeletal system; Obesity; Rheumatoid arthritis; Sarcopenia; Skeletal muscle; Working groups; Asia
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2018-eular.2562

BackgroundThe falls ratio is higher among patients with sarcopenia than among healthy individuals. We reported that the prevalence of sarcopenia was 28% and locomotive syndrome (locomo) was 52% in patients with rheumatoid arthritis (RA)1. Whether patients with RA complicated by sarcopenia show a higher ratio of falls compared to those without sarcopenia remains unclear.ObjectivesWe investigated events of falls and fractures, and predictors of those events in patients with RA.MethodsWe used data from a prospective observational study (CHIKARA study, UMIN000023744) started in 2016. Sarcopenia was diagnosed using the criteria of the Asia Working Group on Sarcopenia2. We counted the number of patients and events of falls and fractures they had per year[A1], and investigated correlations between those events and disease activity, body composition and sarcopenia. Predictors at baseline influencing those events were analysed by uni- and multivariate analysis.ResultsParticipants comprised 100 patients with RA (females, 78%; mean age, 66.1 years). Falls occurred in 21 patients (19 women), as 33 events (mean, 2 times/patient). Fractures occurred in 4 patients (4 women), as 5 events. Table 1 shows predictors for falls, with positive correlations for bone mass index, obesity level, fat percentage, and locomo, and negative correlations for height, trunk muscle mass, and grip strength. No relationships were seen between falls and CRP, DAS28ESR, skeletal muscle mass, and sarcopenia. Height (odds ratio, 0.912; p=0.003) and obesity level (odds ratio, 1.04; p=0.006) were independent predictors by multivariate analysis (table 1). In terms of fracture events, falls was the only predictor (r=0.469, p=0.001).Abstract AB0373 – Table 1Predictors of falls in patients with RAUnivariateMultivariate RPOdds ratio95% CIP Body mass index0.1950.040Obesity revel0.1940.0401.0401.011–1.0690.006Fat percentage0.2110.025Locomotive syndrome0.2370.012Height−0.2630.0050.9120.858–0.9680.003Trunk muscle mass−0.1880.048Grip strength−0.1980.036CRP0.0630.512DAS28ESR−0.0080.932Skeletal muscle mass0.0910.337Sarcopenia−0.0930.327ConclusionsFalls have been reported as significantly more frequent with sarcopenia. However, no relationship was seen between fall events and sarcopenia in this study. We may need to evaluate not only skeletal muscle mass, but also muscle function to predict falls.References[1] Tada M, Yamada Y, Mandai K, et al. Relationship of matrix metalloprotease 3 titer and sarcopenia in patients with rheumatoid arthritis: data from the CHIKARA study. Eular2017:abstract THU0157.[2] Chen LK, Liu LK, Assantachai P, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc2014;15:95–101.Disclosure of InterestNone declared