Evaluating sarcopenia prevalence and relationship with disease activity of primary Sjögren syndrome in females
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Abstract
Background
Primary Sjögren’s syndrome (pSS) leads to impaired muscle function and mass as well as pain and fatigue. Sarcopenia is the pathological reduction of skeletal muscle mass and strength. We aimed to investigate the prevalence of sarcopenia and determine its relationship with disease activity levels in females with primary Sjögren syndrome.
Methods
This cross-sectional study was performed on 62 female patients diagnosed with pSS and 62 female age matched healthy controls. Disease activity was evaluated with the EULAR Sjögren’s syndrome patient reported index (ESSPRI) and EULAR Sjögren’s syndrome disease activity index (ESSDAI), fatigue severity scale (FSS), hospital anxiety and depression scale (HADS), and numerical rating scale (NRS). A simple questionnaire to rapidly diagnose sarcopenia (SARC-F) was used to screen for sarcopenia. Degree of sarcopenia was evaluated by handgrip strength, anterior thigh muscle thickness by USG, the 6-meter walk test (6MWT), and the five times sit-to-stand test (FTSST).
Results
The prevalence of sarcopenia was found to be 36/62 (58.1%) in pSS and 6/62 (9.7%) in healthy controls (p<0.001). HADS anxiety and depression scores and SARC-F scores were significantly higher in pSS (p<0.001). There were significant differences in 6MWT, FTSST, and hand grip strength results in pSS (p<0.001). Anterior thigh muscle thickness was similar in both groups (p=0.298). A positive correlation was found between SARC-F on the one hand and ESSPRI and NRS on the other (r=0.595, p=0.009; r=0.569, p=0.014).
Conclusion
Sarcopenia prevalence was increased in female patients with pSS and there was a relationship of SARC-F scores with pain and disease activity levels.
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References
Barone F, Colafrancesco S. Sjögren's syndrome: from pathogenesis to novel therapeutic targets. Clin Exp Rheumatol 2016;34:58-62.
Colafrancesco S, Priori R, Gattamelata A, et al. Myositis in primary Sjögren's syndrome: data from a multicentre cohort. Clin Exp Rheumatol 2015;33:457-64.
Zhang Y, Wang M. Analysis of 31 cases of female Sjogren’s syndrome patients with changes in muscle mass. Open Access Libr J 2020;7: e6872..
Zeng L, Chen K, Xiao F, et al. Potential common molecular mechanisms between Sjögren syndrome and inclusion body myositis: a bioinformatic analysis and in vivo validation. Front Immunol 2023;21:1-14. doi: 10.3389/fimmu.2023.1161476.
Rocha D, Tessari JA, Mainardi NB, et al. Assessment of muscle mass using chest computed tomography-based quantitative and qualitative measurements in patients with systemic sclerosis: a retrospective study with cross-sectional and longitudinal analyses. Semin Arthritis Rheum 2023;59:152168. doi: 10.1016/j.semarthrit.2023. 152168.
Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019;48: 16–23. doi:10.1093/ageing/afy169.
Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019;393:2636-46. doi: 10.1016/s0140-6736(19)31138-9
Dao T, Green AE, Kim YA, et al. Sarcopenia and muscle aging: a brief overview. Endocrinol Metab 2020;35:716–32. doi:10.3803/enm.2020.405.
Yuan S, Larsson SC. Epidemiology of sarcopenia: prevalence, risk factors, and consequences. Metabolism 2023;144:155533. doi: 10.1016/j.metabol.2023.155533.
Pan L, Xie W, Fu X, et al. Inflammation and sarcopenia: a focus on circulating inflammatory cytokines. Exp Gerontol 2021;154:111544. doi:10.1016/j.exger.2021.111544.
An HJ, Tizaoui K, Terrazzino S, et al. Sarcopenia in autoimmune and rheumatic diseases: a comprehensive review. Int J Mol Sci 2020;21: 5678. doi:10.3390/ijms21165678.
Kara M, Kaymak B, Frontera W, et al. Diagnosing sarcopenia: functional perspectives and a new algorithm from the ISarcoPRM. J Rehabil Med 2021;53: jrm00209. doi:10.2340/16501977-2851.
Öztürk Ö, Feyzioğlu Ö, Sarıtaş F. Pre-sarcopenia is associated with health-related quality of life in patients with primary Sjögren's syndrome. Clin Rheumatol 2023;42:783-91. doi:10.1007/s10067-022-06427-1.
Al Khayyat SG, Falsetti P, Conticini E, et al. Low muscle mass and body composition analysis in a group of postmenopausal women affected by primary Sjögren's syndrome. Reumatologia 2021;59:153-60. doi: 10.5114/reum.2021. 106909.
Colak S, Tekgoz E, Hayme S, Sonaeren I, Cinar M, Yilmaz S. The risk of presarcopenia is increased among female patients with primary Sjögren's syndrome. J Clin Rheumatol 2022 ;28: e161-e5. doi: 10.1097/rhu.0000000000001669.
Albano D, Messina C, Vitale J, Sconfienza LM. Imaging of sarcopenia: old evidence and new insights. Eur Radiol 2020 ;30:2199-208. doi: 10.1007/s00330-019-06573-2.
Liu J, Chen X. Comparison between bioelectrical impedance analyses and dual-energy X-ray absorptiometry for accuracy in assessing appendicular skeletal muscle mass and diagnosing sarcopenia in hospitalized Chinese older adults. Medicine 2023;102:e35250. doi: 10.1097/ MD.0000000000035250.
Shiboski CH, Shiboski SC, Seror R, et al. American College of Rheumatology/European League Against Rheumatism classification criteria for primary Sjögren's syndrome: a consensus and data-driven methodology involving three international patient cohorts. Ann Rheum Dis 2017;76:9-16. doi: 10.1136/ annrheumdis-2016-210571.
Kapuczinski A, Soyfoo MS, De Breucker S, Margaux J. Assessment of sarcopenia in patients with fibromyalgia. Rheumatol Int 2022;42: 279-84. doi: 10.1007/s00296-021-04973-6.
Wratten S, Abetz-Webb L, Arenson E, et al. Development and testing of an alternative responder definition for EULAR Sjögren’s syndrome patient reported index (ESSPRI). RMD Open 2023;9: e002721. doi:10.1136/rmdopen-2022-002721.
Seror R, Bowman SJ, Brito-Zeron P, et al. EULAR Sjögren’s syndrome disease activity index (ESSDAI): a user guide. RMD Open 2015;1:e000022. doi: 10.1136/rmdopen-2014-000022.
Aydemir Ö, Guvenir T, Kuey L, Kultur S. Validity and reliability of Turkish version of hospital anxiety and depression scale. Turk Psikiyatri Derg 1997;8:280-7.
Gök K. The Turkish version of multidimensional assessment of fatigue and fatigue severity scale is reproducible and correlated with other outcome measures in patients with systemic sclerosis. Arch Rheumatol 2016;31:329–32. doi: 10.5606/ archrheumatol.2016.5909.
Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement properties of visual analogue scale, numeric rating scale, and pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. J Pain 2019;20:245–63. doi: 10.1016/ j.jpain.2018.07.009.
Roush J, Heick J, Hawk T, Eurek D, Wallis A, Kiflu D. Agreement in walking speed measured using four different outcome measures: 6-meter walk test, 10-meter walk test, 2-minute walk test, and 6-minute walk test. Internet J Allied Health Sci Pract 2021;19:7. doi:10.46743/1540-580x/ 2021.
Yee XS, Ng YS, Allen JC, et al. Performance on sit-to-stand tests in relation to measures of functional fitness and sarcopenia diagnosis in community-dwelling older adults. Eur Rev Aging Phys Act 2021; 8;18. doi:10.1186/s11556-020-00255-5.
Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr 2016;16:170. doi: 10.1186/s12877-016-0349-4.
Bahat G, Yilmaz O, Kilic C, Oren MM, Karan MA. Performance of SARC-F Turkish in regard to sarcopenia definitions, muscle mass and functional measures. Clin Nutr 2018;37:181. doi: 10.1016/j.clnu.2018.06.1656.
Moschou D, Krikelis M, Georgakopoulos C, et al. Sarcopenia in rheumatoid arthritis. a narrative review. J Frailty Sarcopenia Falls 2023:8:44-52. doi:10.22540/jfsf-08-044.
Tournadre A, Vial G, Capel F, Soubrier M, Boirie Y. Sarcopenia. Joint Bone Spine 2019;86:309–14. doi:10.1016/j.jbspin.2018.08.001.
Zhao R, Li X, Jiang Y, et al. Evaluation of appendicular muscle mass in sarcopenia in older adults using ultrasonography: a systematic review and meta-analysis. Gerontology 2022;68:1174-98. doi: 10.1159/000525758.
Tecer D, Eker Büyüksireci D, Günedi Z, Meray J, Göğüs F. Muscle architecture in patients with primary Sjögren syndrome. Arch Rheumatol 2022;38:101-8. doi: 10.46497/archrheumatol. 2023.9414.
Lin T, Dai M, Xu P, et al. Prevalence of sarcopenia in pain patients and correlation between the two conditions: a systematic review and meta-analysis. J Am Med Dir Assoc 2022;23: 902.e1-e20. doi:10.1016/j.jamda.2022.02.005.