Title: Sarcopenia assessed by DXA and hand-grip dynamometer: a potential marker of damage, disability and myokines imbalance in inflammatory myopathies

Margherita Giannini; Anne-Laure Charles; Charles Evrard; Julien Blaess; Maude Bouchard-Marmen; Léa Debrut; Simone Perniola; Gilles Laverny; Rose-Marie Javier; Anne Charloux; Bernard Geny; Alain Meyer

doi:10.1093/rheumatology/keae207

Title: Sarcopenia assessed by DXA and hand-grip dynamometer: a potential marker of damage, disability and myokines imbalance in inflammatory myopathies

Rheumatology (Oxford). 2024 Mar 27:keae207. doi: 10.1093/rheumatology/keae207. Online ahead of print.

Authors

Margherita Giannini^{1

2

3}, Anne-Laure Charles², Charles Evrard⁴, Julien Blaess^{1

3}, Maude Bouchard-Marmen⁵, Léa Debrut^{2

6}, Simone Perniola⁷, Gilles Laverny^{6

8}, Rose-Marie Javier^{3

8}, Anne Charloux^{2

4}, Bernard Geny^{2

4}, Alain Meyer^{1

2

3

8}

Affiliations

¹ Physiologie et explorations fonctionnelles musculaires, University hospital of Strasbourg, France.
² UR3072 "mitochondrie, stress oxydant et protection musculaire", Centre de Recherche en Biomédecine, University of Strasbourg, France.
³ Centre de Référence des Maladies Auto-immunes Systémiques Rares, University hospital of Strasbourg, France.
⁴ Physiologie et explorations fonctionnelles, University hospital of Strasbourg, France.
⁵ Service de Rhumatologie, University hospital of Québec, University Laval, Québec, Canada.
⁶ Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), University of Strasbourg, INSERM U1258, CNRS UMR 7104, Illkirch, 67404, France.
⁷ Clinical Immunology Unit, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, 00168, Italy.
⁸ Service de Rhumatologie, University hospital of Strasbourg, France.

PMID: 38544289
DOI: 10.1093/rheumatology/keae207

Abstract

Objectives: To assess the ability of dual-energy X-ray absorptiometry (DXA) and hand-grip dynamometer to measure damage in inflammatory myopathies (IM).

Methods: . Forty adult IM patients with a disease duration ≥12 months, low or no disease activity for ≥6 months, were prospectively enrolled. Thirty healthy age and sex-matched volunteers were enrolled as controls. Whole-body DXA and hand-grip dynamometer were used to measure muscle mass, grip strength and diagnose sarcopenia (EWGSOP2 criteria). Relationships between the results of strength in 12 muscles, functional tests, patient-reported disability, IMACS damage score, and history of the disease were assessed. The serum levels of potential molecular actors of the damage were measured.

Results: DXA and grip strength measurements took ≤20 min. Both muscle mass and grip strength were decreased in IM patients vs volunteers (-10% and -30% respectively) with a dispersion that varied widely (IQR -24.3% to + 7.8% and -51.3% to -18.9% respectively). Muscle mass and grip strength were non-redundantly correlated (r up to 0.6, p= 0.0001) with strength in 14 muscles (manual muscle test and hand-held dynamometer), functions (of limbs, respiratory and deglutition muscles), patient-reported disability, damage (extension and severity in muscular and extra-muscular domains), and blood-levels of several myokines. Seven IM patients (17.5%) were sarcopenic. They had the worst damage, functions impairment, disability and history of severe myopathy. Decreased irisin and osteonectin levels were associated with sarcopenia (AUC 0.71 and 0.80, respectively).

Conclusion: DXA and hand-grip dynamometer are useful tools to assess damage in IM. Irisin and osteonectin may play a role in IM damage pathogenesis.

Keywords: antisynthetase syndrome; body composition; dermatomyositis; inclusion body myositis; inflammatory myopathies; myokines; myositis damage; polymyositis; sarcopenia; scleromyositis.