Ab0673 Prevalence and Associated Factors of Sarcopenia in Thai Rheumatoid Arthritis Patients: A Cross-Sectional Study

Background: Sarcopenia refers to decrease in skeletal mass plus low muscle strength and/or low physical performance. Sarcopenia increases risk of falls, fractures, low bone mineral density, comorbidities, and poor quality of life (QoL). Objectives: To determine prevalence and factors associated with sarcopenia, and effect of sarcopenia on quality of life in Thai patients with rheumatoid arthritis (RA). Methods: This cross-sectional study recruited RA patients, age ≥20 years, who attended Rheumatology Clinic of the Chiang Mai University Hospital between May 2023 - November 2023. Patients were evaluated for their skeletal muscle mass (bioelectrical impedance analysis - BIA), grip strength (hand dynamometer), and physical performance (gait speed test). Sarcopenia was defined according to the Asian Working Group for Sarcopenia. Patient characteristics, disease activity, physical disability (Health Assessment Questionnaire - HAQ), QoL (Short Form-36 questionnaire - SF-36), nutrition (mini nutrition assessment), and medications were recorded. Results: Of 299 patients (88.96% female; age 61.27±11.62 years; disease duration 13.86±8.55 years), 35.12% had sarcopenia (27.42% had severe sarcopenia [sarcopenia plus low physical performance]). In multivariable analysis, factors associated with sarcopenia were 10 years increase in disease duration (odd ratio [OR] 1.69, p=0.023), high c-reactive protein (CRP) (OR 2.26, p=0.027), and every 1 cm decrease in calf circumference (OR 1.69, p<0.001). Low body mass index (BMI) and joint deformity were potential associated factors of sarcopenia (OR 1.18, p=0.054 and OR 2.56, p=0.073, respectively) There was no relationship between sarcopenia and disease activity or medication use. When compared with RA patients without sarcopenia, those with sarcopenia significantly had higher HAQ score (adjusted mean difference [AMD] = 0.23 [95%CI 0.08, 0.38], p=0.003), but had lower scores in physical function domain of SF-36 (AMD = -8.30 [95%CI -14.63, -1.97], p=0.010). There were no significant differences in other parts in physical component summary or mental component summery scores of SF-36 between RA patient with and without sarcopenia. Conclusion: About one-third of Thai RA patients had sarcopenia. Long disease duration, high CRP, and low calf circumference were factors associated with sarcopenia. In addition, low BMI and having joint deformity were potential factors of sarcopenia. Sarcopenia affects physical disability and physical function domain in QoL. Physicians should be alert for sarcopenia and encourage muscle-strengthening exercise in order to avoid this condition and improve patients' QoL. In addition, RA treatment should aim to remission at the beginning of the disease in order to prevent deformity which also might be able to prevent sarcopenia and improved in QoL. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.