Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis?

Authors: Abdellah El Maghraoui, François Bertin Ebo’o, Siham Sadni, Abderrahim Majjad, Toufik Hamza, Aziza Mounach

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Osteoporosis is a well-known complication of ankylosing spondylitis (AS). However, data about body composition modifications and muscle performance showed conflicting results. The aim of the study was to determine the prevalence and risk factors of pre-sarcopenia, sarcopenia and cachexia in patients with AS and analyze its relationship with bone loss and symptomatic and severity parameters of the disease.

Methods

Sixty-seven consecutive male patients with AS (mean age of 40.9 ± 11.0 years) and 67 healthy controls were studied. Body composition and bone mineral density (BMD) scans were obtained using DXA. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent of fat mass (%FM) were calculated. Pre-sarcopenia was defined by low skeletal muscle mass (SMI <7.25 kg/m2), sarcopenia by the combined presence of the two following criteria: SMI <7.25 kg/m2 and a low muscle strength (handgrip strength <30 kg) or a low muscle performance (timed get-up-and-go test >10 s) and cachexia by a BMI <20 kg/m2 plus 3 from the 5 following parameters: anorexia, fatigue, handgrip strength <30 kg, CRP >5 mg/l, SMI <7.25 kg/m2.

Results

Pre-sarcopenia, sarcopenia, cachexia, and osteoporosis prevalences were (50.4, 34.3, 11.9, and 16.0) respectively. Patients had a mean 3 kg significant decrease in FFM and a 1 kg/m2 decrease in appendicular mass vs. healthy controls. Pre-sarcopenia, sarcopenia and cachexia were significantly associated to higher BASDAI levels and low BMD.

Conclusion

Our study showed that men with AS had a statistically significant reduction in total and appendicular lean mass that is related to higher disease activity and significantly associated to bone loss.
Appendix
Available only for authorised users
Literature
1.
go back to reference Muscaritoli M, Anker SD, Argiles J, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr. 2010;29:154–9.CrossRefPubMed Muscaritoli M, Anker SD, Argiles J, et al. Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr. 2010;29:154–9.CrossRefPubMed
2.
go back to reference Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014;33:737–48.CrossRefPubMed Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014;33:737–48.CrossRefPubMed
3.
go back to reference El Maghraoui A. Denutrition, cachexia and osteoporosis. Revue du Rhumatisme Monographies. 2013;80:100–4.CrossRef El Maghraoui A. Denutrition, cachexia and osteoporosis. Revue du Rhumatisme Monographies. 2013;80:100–4.CrossRef
4.
go back to reference Sveaas SH, Berg IJ, Provan SA, et al. Circulating levels of inflammatory cytokines and cytokine receptors in patients with ankylosing spondylitis: a cross-sectional comparative study. Scand J Rheumatol. 2015;44:118–24.CrossRefPubMed Sveaas SH, Berg IJ, Provan SA, et al. Circulating levels of inflammatory cytokines and cytokine receptors in patients with ankylosing spondylitis: a cross-sectional comparative study. Scand J Rheumatol. 2015;44:118–24.CrossRefPubMed
5.
go back to reference Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39:412–23.CrossRefPubMedPubMedCentral
6.
go back to reference Toussirot E, Michel F, Wendling D. Bone density, ultrasound measurements and body composition in early ankylosing spondylitis. Rheumatology. 2001;40:882–8.CrossRefPubMed Toussirot E, Michel F, Wendling D. Bone density, ultrasound measurements and body composition in early ankylosing spondylitis. Rheumatology. 2001;40:882–8.CrossRefPubMed
7.
go back to reference Sari I, Demir T, Kozaci LD, et al. Body composition, insulin, and leptin levels in patients with ankylosing spondylitis. Clin Rheumatol. 2007;26:1427–32.CrossRefPubMed Sari I, Demir T, Kozaci LD, et al. Body composition, insulin, and leptin levels in patients with ankylosing spondylitis. Clin Rheumatol. 2007;26:1427–32.CrossRefPubMed
8.
go back to reference Plasqui G, Boonen A, Geusens P, Kroot EJ, Starmans M, van der Linden S. Physical activity and body composition in patients with ankylosing spondylitis. Arthritis Care Res. 2012;64:101–7.CrossRef Plasqui G, Boonen A, Geusens P, Kroot EJ, Starmans M, van der Linden S. Physical activity and body composition in patients with ankylosing spondylitis. Arthritis Care Res. 2012;64:101–7.CrossRef
9.
go back to reference El Maghraoui A. Osteoporosis and ankylosing spondylitis. Joint, Bone, Spine : revue du rhumatisme. 2004;71:291–5.CrossRef El Maghraoui A. Osteoporosis and ankylosing spondylitis. Joint, Bone, Spine : revue du rhumatisme. 2004;71:291–5.CrossRef
10.
go back to reference Ghozlani I, Ghazi M, Nouijai A, et al. Prevalence and risk factors of osteoporosis and vertebral fractures in patients with ankylosing spondylitis. Bone. 2009;44:772–6.CrossRefPubMed Ghozlani I, Ghazi M, Nouijai A, et al. Prevalence and risk factors of osteoporosis and vertebral fractures in patients with ankylosing spondylitis. Bone. 2009;44:772–6.CrossRefPubMed
12.
go back to reference El Maghraoui A, Do Santos Zounon AA, Jroundi I, et al. Reproducibility of bone mineral density measurements using dual X-ray absorptiometry in daily clinical practice. Osteoporosis Int. 2005;16:1742–8.CrossRef El Maghraoui A, Do Santos Zounon AA, Jroundi I, et al. Reproducibility of bone mineral density measurements using dual X-ray absorptiometry in daily clinical practice. Osteoporosis Int. 2005;16:1742–8.CrossRef
13.
go back to reference Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organization technical report series 1995;854:1–452. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organization technical report series 1995;854:1–452.
14.
go back to reference Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY. Measurement precision of body composition variables using the lunar DPX-L densitometer. J Clin Densitom. 2000;3:35–41.CrossRefPubMed Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY. Measurement precision of body composition variables using the lunar DPX-L densitometer. J Clin Densitom. 2000;3:35–41.CrossRefPubMed
15.
go back to reference Abernathy RP, Black DR. Healthy body weights: an alternative perspective. Am J Clin Nutr. 1996;63:448S–51S.PubMed Abernathy RP, Black DR. Healthy body weights: an alternative perspective. Am J Clin Nutr. 1996;63:448S–51S.PubMed
16.
go back to reference Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15:116–22.CrossRefPubMed Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999;15:116–22.CrossRefPubMed
17.
go back to reference Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147:755–63.CrossRefPubMed Baumgartner RN, Koehler KM, Gallagher D, et al. Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998;147:755–63.CrossRefPubMed
18.
19.
go back to reference Dos Santos FP, Constantin A, Laroche M, et al. Whole body and regional bone mineral density in ankylosing spondylitis. J Rheumatol. 2001;28:547–9.PubMed Dos Santos FP, Constantin A, Laroche M, et al. Whole body and regional bone mineral density in ankylosing spondylitis. J Rheumatol. 2001;28:547–9.PubMed
20.
go back to reference Marcora S, Casanova F, Williams E, Jones J, Elamanchi R, Lemmey A. Preliminary evidence for cachexia in patients with well-established ankylosing spondylitis. Rheumatology. 2006;45:1385–8.CrossRefPubMed Marcora S, Casanova F, Williams E, Jones J, Elamanchi R, Lemmey A. Preliminary evidence for cachexia in patients with well-established ankylosing spondylitis. Rheumatology. 2006;45:1385–8.CrossRefPubMed
21.
go back to reference Visser M. Towards a definition of sarcopenia--results from epidemiologic studies. J Nutr Health Aging. 2009;13:713–6.CrossRefPubMed Visser M. Towards a definition of sarcopenia--results from epidemiologic studies. J Nutr Health Aging. 2009;13:713–6.CrossRefPubMed
22.
go back to reference Cederholm TE, Bauer JM, Boirie Y, Schneider SM, Sieber CC, Rolland Y. Toward a definition of sarcopenia. Clin Geriatr Med. 2011;27:341–53.CrossRefPubMed Cederholm TE, Bauer JM, Boirie Y, Schneider SM, Sieber CC, Rolland Y. Toward a definition of sarcopenia. Clin Geriatr Med. 2011;27:341–53.CrossRefPubMed
23.
go back to reference Lainscak M, Filippatos GS, Gheorghiade M, Fonarow GC, Anker SD. Cachexia: common, deadly, with an urgent need for precise definition and new therapies. Am J Cardiol. 2008;101:8E–10E.CrossRefPubMed Lainscak M, Filippatos GS, Gheorghiade M, Fonarow GC, Anker SD. Cachexia: common, deadly, with an urgent need for precise definition and new therapies. Am J Cardiol. 2008;101:8E–10E.CrossRefPubMed
24.
go back to reference Seelaender M, Laviano A, Busquets S, Puschel GP, Margaria T, Batista Jr ML. Inflammation in Cachexia. Mediat Inflamm. 2015;2015:536954. Seelaender M, Laviano A, Busquets S, Puschel GP, Margaria T, Batista Jr ML. Inflammation in Cachexia. Mediat Inflamm. 2015;2015:536954.
25.
go back to reference El Maghraoui A, Sadni S, Rezqi A, Bezza A, Achemlal L, Mounach A. Does Rheumatoid Cachexia Predispose Patients with Rheumatoid Arthritis to Osteoporosis and Vertebral Fractures? J Rheumatol. 2015;42:1556–62.CrossRefPubMed El Maghraoui A, Sadni S, Rezqi A, Bezza A, Achemlal L, Mounach A. Does Rheumatoid Cachexia Predispose Patients with Rheumatoid Arthritis to Osteoporosis and Vertebral Fractures? J Rheumatol. 2015;42:1556–62.CrossRefPubMed
26.
go back to reference Summers GD, Deighton CM, Rennie MJ, Booth AH. Rheumatoid cachexia: a clinical perspective. Rheumatology. 2008;47:1124–31.CrossRefPubMed Summers GD, Deighton CM, Rennie MJ, Booth AH. Rheumatoid cachexia: a clinical perspective. Rheumatology. 2008;47:1124–31.CrossRefPubMed
28.
go back to reference Kim J, Wang Z, Heymsfield SB, Baumgartner RN, Gallagher D. Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method. Am J Clin Nutr. 2002;76:378–83.PubMed Kim J, Wang Z, Heymsfield SB, Baumgartner RN, Gallagher D. Total-body skeletal muscle mass: estimation by a new dual-energy X-ray absorptiometry method. Am J Clin Nutr. 2002;76:378–83.PubMed
29.
go back to reference Henderson RC, Lark RK, Renner JB, et al. Dual X-ray absorptiometry assessment of body composition in children with altered body posture. J Clin Densitom. 2001;4:325–35.CrossRefPubMed Henderson RC, Lark RK, Renner JB, et al. Dual X-ray absorptiometry assessment of body composition in children with altered body posture. J Clin Densitom. 2001;4:325–35.CrossRefPubMed
30.
go back to reference El Maghraoui A, Borderie D, Cherruau B, Edouard R, Dougados M, Roux C. Osteoporosis, body composition, and bone turnover in ankylosing spondylitis. J Rheumatol. 1999;26:2205–9.PubMed El Maghraoui A, Borderie D, Cherruau B, Edouard R, Dougados M, Roux C. Osteoporosis, body composition, and bone turnover in ankylosing spondylitis. J Rheumatol. 1999;26:2205–9.PubMed
31.
go back to reference Maillefert JF, Aho LS, El Maghraoui A, Dougados M, Roux C. Changes in bone density in patients with ankylosing spondylitis: a two-year follow-up study. Osteoporosis Int. 2001;12:605–9.CrossRef Maillefert JF, Aho LS, El Maghraoui A, Dougados M, Roux C. Changes in bone density in patients with ankylosing spondylitis: a two-year follow-up study. Osteoporosis Int. 2001;12:605–9.CrossRef
32.
go back to reference Briot K, Garnero P, Le Henanff A, Dougados M, Roux C. Body weight, body composition, and bone turnover changes in patients with spondyloarthropathy receiving anti-tumour necrosis factor {alpha} treatment. Ann Rheum Dis. 2005;64:1137–40.CrossRefPubMedPubMedCentral Briot K, Garnero P, Le Henanff A, Dougados M, Roux C. Body weight, body composition, and bone turnover changes in patients with spondyloarthropathy receiving anti-tumour necrosis factor {alpha} treatment. Ann Rheum Dis. 2005;64:1137–40.CrossRefPubMedPubMedCentral
33.
go back to reference Durnez A, Paternotte S, Fechtenbaum J, et al. Increase in bone density in patients with spondyloarthritis during anti-tumor necrosis factor therapy: 6-year followup study. J Rheumatol. 2013;40:1712–8.CrossRefPubMed Durnez A, Paternotte S, Fechtenbaum J, et al. Increase in bone density in patients with spondyloarthritis during anti-tumor necrosis factor therapy: 6-year followup study. J Rheumatol. 2013;40:1712–8.CrossRefPubMed
34.
go back to reference Buck M, Houglum K, Chojkier M. Tumor necrosis factor-alpha inhibits collagen alpha1(I) gene expression and wound healing in a murine model of cachexia. Am J Pathol. 1996;149:195–204.PubMedPubMedCentral Buck M, Houglum K, Chojkier M. Tumor necrosis factor-alpha inhibits collagen alpha1(I) gene expression and wound healing in a murine model of cachexia. Am J Pathol. 1996;149:195–204.PubMedPubMedCentral
35.
go back to reference Marcora SM, Chester KR, Mittal G, Lemmey AB, Maddison PJ. Randomized phase 2 trial of anti-tumor necrosis factor therapy for cachexia in patients with early rheumatoid arthritis. Am J Clin Nutr. 2006;84:1463–72.PubMed Marcora SM, Chester KR, Mittal G, Lemmey AB, Maddison PJ. Randomized phase 2 trial of anti-tumor necrosis factor therapy for cachexia in patients with early rheumatoid arthritis. Am J Clin Nutr. 2006;84:1463–72.PubMed
36.
go back to reference Briot K, Gossec L, Kolta S, Dougados M, Roux C. Prospective assessment of body weight, body composition, and bone density changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor-alpha treatment. J Rheumatol. 2008;35:855–61.PubMed Briot K, Gossec L, Kolta S, Dougados M, Roux C. Prospective assessment of body weight, body composition, and bone density changes in patients with spondyloarthropathy receiving anti-tumor necrosis factor-alpha treatment. J Rheumatol. 2008;35:855–61.PubMed
Metadata
Title
Is there a relation between pre-sarcopenia, sarcopenia, cachexia and osteoporosis in patients with ankylosing spondylitis?
Authors
Abdellah El Maghraoui
François Bertin Ebo’o
Siham Sadni
Abderrahim Majjad
Toufik Hamza
Aziza Mounach
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1155-z

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue