SAT0358 Decreased body fat, lean body mass and bone mineral density in patients with systemic sclerosis are associated with disease activity and physical activity
Sabína OreskáMaja ŠpiritovićPetr ČesákM. CesakHana ŠtorkánováKateřina KubínováMartin KleinLucia VernerováOlga RůžičkováH. MannKarel PavelkáLadislav ŠenoltJiří VencovskýRadim BečvářMichal Tomčík
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Background
Systemic sclerosis (SSc) is characterized 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/tumor 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±0.5kg, 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±6.8kg, p=0.0003) and BIA (LBM: 53.2±8.7 vs. 47.7±7.0kg, 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.Acknowledgements
Supported by AZV-16–33574A, GAUK-214615.Disclosure of Interest
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Densitometry
A self-administrated questionnaire was performed to clarify the actual circumstances of community-based screening for osteoporosis. The results revealed that only 25 percent of communities performed follow-up of high-risk participants, representing a disappointing result for assessing evidence of the benefits of measuring bone mineral density in preventing osteoporosis. Secondly, a review of the literature was performed to clarify the benefits of measuring bone mineral density in preventing osteoporosis. The review revealed that increased measurements could predict fractures among elderly and peri- and postmenopausal women, and elderly men.
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Changes in body composition, including a decrease in muscle and bone mass, accompany aging. Analyse the influence of lean mass on bone mineral density, related to physical activity, in elderly women. 37 women were included in this study via an osteoporosis consultation. Body composition and bone mineral density (BMD) measurements were performed using Dual-energy X-ray absorptiometry methodology (DXA). The BMD was measured at the femoral neck. Each participant had a physical activity test to respond and had to perform handgrip, a four meter walk and one leg balance. Simple regression analyze showed a positive association between lean masse et BMD; after multiple linear regression analysis, we found a positive association between BMD, lean mass, and one leg balance; lean masse and one leg balance were two independent variable. Bone Mineral density was signicantly associated to lean mass and one leg balance.
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Objective To investigate the body components and bone mineral density(BMD) in healthy young men, providing the basis for the prevention, diagnosis and treatment of osteoporosis. Methods Body components, whole bone density, and bone density of arms and lumbar vertebrae in 155 healthy young men aged 18.0-23.9 were measured by dual energy X-ray absorptiometry. Results BMD of arms increased with age, while the BMC and BMD of other parts and the whole bone density had no significant age specific differences (P0.05). BMD of all parts except lumbar vertebrae increased with increasing BMI(P0.01). The correlation coefficient(r) of L_(2-4) and lean body mass was 18.5-24.9, lean body mass increased with increasing BMI, and when BMI increased to 25 and above, the lean body mass no longer increased. Conclusions Lean body mass may be the main factor influencing the bone density.
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This report provides general information about osteoporosis and describes the use of bone densitometry as a tool to screen for, diagnose and manage osteoporosis in white postmenopausal women. Discussion is limited to white women because of lack of research on osteoporosis in men, and in women of different racial and ethnic groups. The report does not evaluate the safety and efficacy of all bone densitometry devices, but focuses on the two diffusing most rapidly in Minnesota--dual x-ray absorptiometry (DXA or DEXA) and quantitative computed tomography (QCT). Osteoporosis is a degenerative bone disease that affects approximately 24 million Americans. Of that number 33 percent are post-menopausal women who have decreased bone density due to lowered estrogen levels. Because the estimated cost of osteoporosis-related fractures in the United States is between $8 and $10 billion each year, there is great interest in the diagnosis, prevention and treatment of the disease. Of all related fractures, hip fractures pose the most serious health problem. The incidence of this fracture appears to be increasing, with 250,000 to 300,000 occurring each year Treatment options are limited, if a person's bone mass or density has deteriorated to the point where fractures may occur. Preventive measures should therefore be undertaken by all women early in life to decrease their risk of osteoporosis. Based on available evidence, the HTAC concludes that state-of-the-art bone densitometry is safe and indicated as a diagnostic and treatment aid for postmenopausal women at risk for the disease. However, bone densitometry is not indicated as a broad screening tool for all postmenopausal women, regardless of whether they are at risk for the disease.
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Since its first characterisation, osteoporosis has always been defined on an anatomical basis. The term osteoporosis refers to a reduction (or atrophy) in the amount of bone tissue and to microarchitectural deterioration without any mineralisation defect. Its clinical significance lies in the fractures (vertebral fracture, Colles' fracture and hip fracture) that occur spontaneously or after a minimal trauma. During the past 15 years, developments in technology of bone mass measurement (osteodensitometry) currently allow a diagnosis of osteoporosis at its anatomical stage characterised by a reduction in bone mass (osteopenia) without any symptom. A definition based on densitometry offers the major advantage of an early diagnosis, well before the development of fractures. It has been validated recently by several prospective studies which have confirmed the close relationship between the decrease in bone mass and the fracture risk. This modern densitometric approach of osteoporosis has major therapeutic implications. Indications of curative treatments of osteoporosis has major therapeutic implications. Indications of curative treatments of osteoporosis should be reconsidered according to the contribution of bone densitometry.
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OBJECTIVE To understand osteoporosis and bone mineral density measurement of middle-aged and aged people in Huairou of Beijing, put forward the prevention measures. METHODS Used Metriscan dual energy X-ray absorptiometry to detect bone mineral density in 894 cases, relationship between bone mineral density measurement and T-Score score (T), the prevalence of osteoporosis. RESULTS Every 10 years as a age period, a total of five age periods, age increased while bone mineral density, T value gradually declined, there were significant differences in bone mineral density value, T value in each age group (P﹤0.05). The bone mineral density and T value in each group were different between genders (P﹤0.05). (2) In 40-49 years, 50-59 years, 60-69 years, and 70-79 years, and 80 years groups, male osteoporosis prevalence was 2.31%, 4.76%, 17.11%, 33.33%、 64.29%, and female 3.31%, 11.97%, 35.56%, 61.54%, 75.00%. Female osteoporosis prevalence was higher than male. Older than 50 years, differences in prevalence were found between genders (P﹤0.05). CONCLUSION Determination of bone density contributes to the early detection of osteoporosis, osteoporosis prevalence of elderly in Huairou the increases with increasing age. Women have lower bone density and their osteoporosis prevalence is more serious, who is the main controlled target.
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