Prevalence and clinical association of sarcopenia among Thai patients with systemic sclerosis

Abstract

Patients with systemic sclerosis (SSc) have some potential factors associated with an increased risk of sarcopenia. There has been currently no study to examine such associations in SSc patients. We aimed to determine the prevalence of sarcopenia among SSc patients and examine its association with clinical manifestations and laboratory tests. A cross-sectional study was conducted in 180 adult SSc patients at the Scleroderma Clinic, Khon Kaen University, Thailand, between July 2019 and April 2020. Clinical data, laboratory tests for inflammatory markers, serology, hormone, body composition by dual-energy X-ray absorptiometry, handgrip strength, functional lower extremity strength, and usual gait speed were collected and measured. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia. One hundred and eighty patients were recruited. Ninety-four cases (52.2%) were the diffuse cutaneous SSc subset. The respective mean age and duration of disease was 58.8 ± 9.4 and 6.2 ± 5.3 years. Sarcopenia was revealed in 41 SSc patients for a prevalence of 22.8% (95% CI 12.1–34.8), while the prevalence was higher in patients with the diffuse cutaneous SSc (dcSSc) compared to the limited cutaneous SSc. BMI at the onset of SSc and C-reactive protein > 5 mg/dL were significantly associated with sarcopenia with a respective OR of 0.60 (95% CI 0.48–0.75) and 3.18 (1.06–9.54). Sarcopenia is common in patients with SSc, but the prevalence is more pronounced in the dcSSc. Inflammatory markers, particularly the CRP level, are strongly associated. BMI at the onset had a negative association with sarcopenia among SSc patients.

Sarcopenia in systemic sclerosis: prevalence and impact—a systematic review and meta-analysis

“…Online supplemental table S6 provides an overview of the characteristics of the studies included in this meta-analysis. A total of 815 patients with SSc from nine eligible studies4–7 12–16 published between 2018 and 2022 were included. The mean age of the patients ranged from 52.5 to 64.1 years, while the mean duration of SSc ranged from 6 to 12.8 years.…”

“…The mean age of the patients ranged from 52.5 to 64.1 years, while the mean duration of SSc ranged from 6 to 12.8 years. The majority of the studies (eight out of nine) had a cross-sectional design,4–6 12–16 with one being a retrospective cohort study 7. The studies were conducted in various regions, with five from Europe,5–7 12 16 two from South America13 15 and two from Asia 4 14…”

“…According to the AHRQ and NOS ratings, eight of the eligible studies4–7 12 14–16 were of moderate quality, with only one article13 classified as high quality (online supplemental tables S7 and S8).…”

“…Additionally, the disease subtype is an important factor that affects the prevalence of sarcopenia. Patients with dcSSc are more prone to develop sarcopenia 14. Moreover, age is an essential factor that influences the onset and course of sarcopenia, with the prevalence of sarcopenia increasing with age.…”

“…In recent years, the presence of sarcopenia in SSc has garnered attention in several studies 4–7 12–16. The documented prevalence of sarcopenia in SSc varies widely from 10.7% to 42% among different studies, which can be attributed to several factors 4 5.…”