Qualificações e Defesas

Resumo

Axial spondyloarthritis (axial-SpA) is a chronic rheumatological disease that presents an important inflammatory component that, associated with pain and stiffness of the spine, contributes to the reduction of the patient's muscle mass, a condition known as sarcopenia. Sarcopenia is responsible for increasing the risk of falls and fractures, impairing the ability to perform activities of daily living, and increasing morbidity and mortality in general. This study aims to evaluate the prevalence of sarcopenia in patients with axial spondyloarthritis. This effect also increases the risk of fractures and a reduction in bone mineral density. However, there is no well-defined association between fracture risk factors and bone mineral density with body composition in patients with axial SpA. Objective: To evaluate the association between body composition and bone mineral density with risk factors for sarcopenia and fractures in patients with axial SpA. Subjects and Methods: Observational, cross-sectional, analytical study that evaluated 57 patients with axial SpA followed at the rheumatology outpatient clinic of the Universidade Federal do Semi-Árido (UFERSA). They were invited to answer questionnaires on clinical, sociodemographic and nutritional characterization (disease duration, medications in use, comorbidities, falls). Data from the medical records were reviewed for laboratory characterization. In addition, data were collected from the medical records (laboratory tests - HLAB27, inflammatory activity tests, C-reactive protein/ESR). The functional capacity of the patients was assessed by the Bath Ankylosing Spondylitis Functional Index (BASFI) (BASFI) and disease activity (BASDAI). All patients underwent assessment of handgrip strength through the handgrip test, aiming to correlate these data with the prevalence of sarcopenia assessed through physical performance and mobility tests through the Time Up and Go (TUG) test and lower limb strength with a 400 m walk through the sit-to-stand test (SST). They also underwent radiological assessment (X-ray of the spine, hip and sacroiliac joints), bone mineral density (lumbar spine, femur and radius) and body composition through dual-energy X-ray bone densitometry (DXA). The study showed a prevalence of 40.35 of probable sarcopenia, 10.5 of sarcopenia, 5.6 with pre-sarcopenia. Furthermore, there was a statistical correlation between probable sarcopenia and reduced appendicular mass index (AMI) and low weight, and patients with sarcopenia had a higher BASFI index and reduced appendicular mass. Furthermore, there was no correlation between probable sarcopenia and sarcopenia with radiological findings and disease duration. Other correlations were not possible due to the small sample size, but the need to screen patients with axial SpA is clear, since they had a high prevalence of probable sarcopenia, indicating possible muscle dysfunction.