5th International Conference of Orthopedic Surgeons and Rheumatology

Biography

Biography: Pawel Szulc

Abstract

Sarcopenia (low muscle mass) and dynapenia (low muscle strength) are consequences of rheumatoid arthritis (RA). However, their risk factors have been poorly studied. RA is more frequent in women who have lower muscle mass. RA starts early (fourth decade) and its negative effects accumulate over long years. Long RA duration is associated with high risk of sarcopenia. Acute inflammatory episodes and chronic inflammation are characterized by increased secretion of inflammatory cytokines stimulating muscle catabolism. Inflammatory episodes are characterized by joint stiffness, muscle weakness and pain, which are associated with low physical activity. Long-lasting RA is associated with joint deformities and reduced amplitude of joint movements. This chronic status may impose sedentary lifestyle, which increases the risk of sarcopenia. Reduced joint movements and voluntary limitation of the use of the affected limb result in local muscle loss. Furthermore, RA treatment (high doses of glucocorticoids) stimulates muscle catabolism and increases the risk of sarcopenia.rnThis risk of sarcopenia is higher in patients in RA who did not receive appropriate treatment or were not compliant. The risk of sarcopenia is higher in elderly patients who could not receive modern therapy in the initial phase of the disease. Moreover, the risk of sarcopenia in RA differs between the countries according to the availability of the up-to-date treatment. rnPatients with sarcopenia limit their physical activity, which further aggravates muscle loss. Moreover, RA is associated with higher risk of osteoporosis. In these patients, osteoporosis and higher risk of fall due to sarcopenia jointly increase the risk of fracture.rnThus, female sex, long duration of the disease, high activity of the inflammatory status, low physical activity, joint deformities and long-term glucocorticoid therapy increase the risk of sarcopenia in patients with RA. Sarcopenia is associated with further reduction of physical activity and higher risk of fall and fracture.