Changes in health-related quality of life (QoL) due to hip, humeral, ankle, spine, and distal forearm fracture were measured in Russian adults age 50 years or more over the first 18 months after fracture. The accumulated mean QoL loss after hip fracture was 0.5 and significantly greater than after fracture of the distal forearm (0.13), spine (0.21), proximal humerus (0.26), and ankle (0.27). Introduction Data on QoL following osteoporotic fractures in Russia are scarce. The present study evaluated the impact of hip, vertebral, proximal humerus, distal forearm, and ankle fracture up to 18 months after fracture from the Russian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study. Methods Individuals age ≥ 50 years with low-energy-induced humeral, hip, clinical vertebral, ankle, or distal forearm fracture were enrolled. After a recall of pre-fracture status, HRQoL was prospectively collected over 18 months of follow-up using EQ-5D-3L. Multivariate regression analysis was used to identify determinants of QALYs loss.

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Background:Sarcopenia, characterized by low muscle strength and low muscle quantity or quality and associated with increased risks of falling and mortality. The prevalence of sarcopenia is 37% among patients with RA [1]. However, in clinical practice settings, sarcopenia among RA patients remains underdiagnosed. The SARC-F questionnaire [2] was recommended by the European Working Group on Sarcopenia in Older People (EWGSOP) before performing muscle strength tests and assessment muscle mass.Objectives:To evaluate the diagnostic value of the SARC-F questionnaire for the screening of sarcopenia (SP) in women with rheumatoid arthritis (RA).Methods:83 women (average age 59±8 years) with RA without aseptic bone necrosis, joint replacement and severe comorbidities were recruited. All patients were interviewed with the SARC-F questionnaire. The summation score ≥ 4 corresponded to cut-off for suspected sarcopenia. Sarcopenia was evaluated using the European Working Group on Sarcopenia in Older People (EWGSOP2), which included dual-energy X-ray absorptiometry (DXA), handgrip strength or chair stand test, and gait speed. The sensitivity, specificity, positive and negative prognostic values of the SARC-F questionnaire were estimated.Results:Confirmed SP was diagnosed in 20 (24%) RA patients, who had low muscle strength and mass. When conventional cut-off point (≥4) for SARC-F questionnaire was applied, only 30% of the patients with SP met this condition (sensitivity 30%, 95% confidence interval [95% CI] 13% to 54%), and 41% of the patients without SP did not meet this condition (specificity 41%, 95% CI 29% to 54%). Positive and negative prognostic values were 14% (95% CI 6% to 29%) and 65% (95% CI 48% to 79%), respectively.Conclusion:The SARC-F questionnaire alone is not adequate for screening of SP in RA patient. It is necessary to develop other simple screening methods that can easily be carried out in real clinical practice to identify individuals with possible SP for further diagnostic tests.References:[1]Torii M, Hashimoto M, Hanai A, et al. Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis. Modern Rheumatology, 2018;29(4):589-595. doi:10.1080/14397595.2018.1510565.[2]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169.Disclosure of Interests:None declared

ObjectivesTo assess body composition and bone mineral density (BMD) in rheumatoid arthritis (RA) women compared to patients with osteoarthritis (OA).Methods133 women with RA and 45 women with OA aged 50 and over were enrolled in the study. Body composition (fat mass (FM), lean mass and bone mineral component (BMC)) and BMD of the lumbar spine, femoral neck and total hip were measured using dual-energy X-ray absorptiometry (DXA). Appendicular muscle mass (AMM) and appendicular mass index (AMI) were calculated. Muscle strength was assessed in all patients. The criteria of the European Working group on Sarcopenia in Older people 2 (EWGSOP2) were used for low muscle mass and sarcopenia. Osteoporosis was determined in accordance with WHO criteria.ResultsMean age of RA patients and women with OA was 61.3±7.1 and 61.9±6.2 years, respectively (p>0.05). BMC and AMM were lower in RA patients than in women with OA: BMC - 1948.6±425.7g and 2167.1±398.1g, respectively (p=0.004); AMM - 17.5±2.9 kg and 20.1±2.7 kg, respectively (p<0.001). 27 (20.3%) RA women and only 1 (2.2%) person with OA had low AMM (p=0.004). The mean value of AMI was 6.8±1.0 kg/m2 and 7.5±0.9 kg/m2 in RA and OA patients, respectively (p<0.001). Total FM was 28.3±8.5 kg and 33.2±9.8 kg in RA and OA women, respectively (p=0.003). At the same time, we found no differences in the percentage of fat mass: 39.2±5.7% in RA patients and 39.9±5.8% in persons with OA (p>0.05). Overfat was discovered in 99 (77.4%) and 38 (84.4%) in women with RA and OA, respectively (p>0.05). All women with low AMM/AMI had low muscle strength and were diagnosed with confirmed sarcopenia.In RA patients BMD at any region was less than in women with OA: in the lumbar spine – 1.026±0.174 g/сm2 and 1.114±0.177 g/сm2, respectively (p=0.009); in the femoral neck – 0.844±0.151 g/сm2 and 0.914±0.137 g/сm2, respectively (p=0.005) and in the total hip 0.878±0.148 g/сm2 and 0.986±0.117 g/сm2, respectively (p<0.001). Normal BMD was found in 33 (24.8%) and 24 (53.3%) women with RA and OA, respectively (p=0.0004). 42 (31.6%) patients with RA and 6 (15.4%) women with OA had osteoporosis (p=0.017).ConclusionRA patients had lower BMC, AMM/AMI, total FM and BMD compared to women with OA, and they were significantly more likely to have sarcopenia and osteoporosis.Disclosure of InterestsNone declared

Background:Rheumatoid arthritis (RA) is a complex inflammatory disease that modifies body composition. Using the dual-energy x-ray absorptiometry (DXA) in RA patients could be a method for body composition changes detection.Objectives:To study the body composition using DXA in patients with RA.Methods:The study involved 79 women with RA, median age 60 [55; 65] years. The bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry using «Discovery A» (Hologic, USA). Assessment of body composition was carried out, using the program «Whole body». Sarcopenia (SP) was diagnosed as a decrease in appendicular mass index (AMI) <6.0 kg/m2. Osteoporosis (OP) was diagnosed as a decrease in T-score <-2.5 SD. Osteosarcopenia was determined when T-score was <-1.0 SD, AMI was <6.0 kg/m2, osteosarcopenic obesity - T-score was <-1.0 SD, AMI was <6.0 kg/m2and total fat was >35%.Results:The mean duration of RA was 9 [3; 11] years. The mean body mass index (BMI) was 27.6±4.8 kg/m2. Disease activity score in 28 joints-erythrocyte sedimentation rate was 4.5±1.3 points for the group. 39 (49.3%) patients used oral glucocorticoids continuously. Appendicular muscle mass and AMI were on average 17.8±3.0 kg and 6.8±1.0 kg/m2, respectively. AMI <6 kg/m2was detected in 20 (25.3%) patients. 56 (70.9%) women with RA had total fat > 35%, while only 22 (27.8%) of women with RA had obesity according to BMI (BMI >30 kg/m2). Isolated OP was found in 13 (16.5%), osteosarcopenia in 7 (8.9%) and osteosarcopenic obesity in 13 (16.5%) patients RA. No cases with isolated sarcopenia or sarcopenic obesity were detected. Only 3 (3.8%) patients did not have appendicular muscle mass, AMI and BMD decrease and overfat or obesity.Conclusion:About 97% women with RA had abnormal body composition phenotype: 16,5% - OP, 8.9% -osteosarcopenia, 16,5% - osteosarcopenic obesity and 54,4% - overfat.Disclosure of Interests:None declared