POS0135 ASSESSMENT OF SARCOPENIA IN PATIENTS WITH TAKAYASU ARTERITIS

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Background: Takayasu Arteritis (TAK) is a systemic vasculitis characterized by inflammation of the aorta and its major branches, including the arterial system of the extremities. Vascular inflammation and arterial ischemia lead to negative impacts on the muscle groups supplied by these arteries. Objectives: In this study, we aimed to assess the impact of ischemia and inflammation on muscle mass and muscle function in patients with TAK and to examine the affecting factors on muscle mass and function; such as the duration of damage, disease activity, and treatment selection by using ultrasonography. Additionally, the prevalence of secondary sarcopenia in patients with TAK was evaluated using two distinct methods. Methods: In our study, we included 103 patients diagnosed with TAK according to the ACR 1990 criteria, who were under follow-up at the Vasculitis Clinic of the Department of Internal Medicine, Division of Rheumatology at Marmara University. We also included 75 healthy volunteers with comparable age and sex characteristics. The muscle strength of the participants was assessed using handgrip and chair-stand tests, while muscle mass was evaluated through two separate measurement: bioelectrical impedance analysis and ultrasonography. For ultrasonographic measurement, the quadriceps which is the most rapidly affected by sarcopenia, and the biceps muscle, selected to assess the impact of arterial involvement in TAK on regional muscle mass, were chosen. Therefore muscle thickness was measured in two regions: the anterior arm and the anterior thigh. Threshold values were defined following the principles of STAR algorithm. The association between disease activation and treatment choice with muscle strength and muscle function in patients with TAK was also investigated. Results: Among the TAK patients who participated in the study, 88.3% were female, 11.7% were male, and the median age was 43 years. According to the right quadriceps STAR (ISarcoPRM), sarcopenia was observed in 30 (29.13%) of the patient group and 9 (12%) of the healthy control (HC) group, with the statistically significant difference (p<0.001). According to the EWSGOP2 algorithm and Turkish threshold values, 58 participants (55,31%) in the patient group were identified with probable sarcopenia, while 3 participants (2.91%) were diagnosed with confirmed sarcopenia. Additionally, 20 participants (26,67%) in the HC group were classified as sarcopenic with reduced muscle function. The agreement between EWSGOP2 and STAR (ISarcoPRM) algorithms was moderate (p=000 k:0.547 in kappa analysis). The handgrip strength and chair stand test (CST) which are used to assess muscle strength were found to be significantly lower in the patient group compared to the healthy control group. (p<0,001) There was no significant difference between the two groups in muscle mass according to measurement obtained by the bioelectrical impedance analysis (BIA) method. However, quadriceps muscle thickness and the STAR index were significantly lower in the patient group (p<0.001). Conclusion: In our study, muscle strength and muscle mass were observed to be significantly reduced in patients with TAK compared to the healthy population. The prevalence of sarcopenia was found to be 58,2% according to the EWSGOP2 algorithm using Turkish thresholds and %29,13 according to the STAR (ISarcoPRM) criteria. This represents an increase in prevalence compared to the healthy population. Our findings suggest that sarcopenia should be considered as a significant factor influencing both the quality of daily life and activity management in the ongoing assessment and management of patients with Takayasu arteritis. Our study reveals that in chronic diseases such as TAK, where vasculitic involvement of the arteries directly supplying the muscles accompanies systemic inflammation, the assessment of muscle mass using ultrasonography (US) is a more sensitive method that facilitates earlier diagnosis. The capability to perform regional measurements, its ease of use, and the simultaneous evaluation of both muscle mass and muscle quality indicate that ultrasonography could serve as an effective follow-up method for patients with TAK. REFERENCES: [1] Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatology (Oxford). 2014;53(5):793-801 [2] Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. [3] Kara M, Kaymak B, Frontera W, Ata AM, Ricci V, Ekiz T, et al. Diagnosing sarcopenia: Functional perspectives and a new algorithm from the ISarcoPRM. J Rehabil Med. 2021;53(6):jrm00209 Table 1 . Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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