ABSTRACT
Aim: In this study, we evaluated the presence of sarcopenia multidimensionally in patients with knee osteoarthritis (OA) using clinical, ultrasonographic and biochemical parameters, and in this respect, it was aimed to investigate the relation between OA and sarcopenia and to identify the most practical, easily accessible and inexpensive method for investigating sarcopenia.
Materials and methods : 102 patients with clinical and radiological diagnosis of knee osteoarthritis and 33 healthy control subjects were included in the study. A total of 135 subjects were evaluated using the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria of sarcopenia. The first group consists of (OA) patients with sarcopenia, the second group consist of OA patients without sarcopenia and the third group is controls subjects. The detailed musculoskeletal system examination of the patients included in the study was carried out by a single physician, and complete blood count, renal function tests, electrolytes, total protein, albumin, 25 (OH) vitamin D, serum leptin, serum adiponectin, PTH, TSH and vitamin B12 values were recorded using the venous blood samples taken from the study group.Dual-X-ray absorptiometry (DEXA) is used to measure Body composition parameters and muscle mass measurements, isometric muscle strength evaluations, handgrip strength and gait speeds for diagnosis of sarcopenia. Short-form -36 (SF-36) The Nutritional Assessment-short form (MNA), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the International Physical Assessment Questionnaire Short Form (IPAQ-SF) and the Center for Epidemiologic Studies Depression Scale (CES-D scale) were administered to every patient as outcome measures.
Results: The mean age of the group with sarcopenia was statistically higher than the other two groups (p <0.001). The weight, body mass index (BMI), waist circumference, upper mid-arm circumference, thigh and leg circumference of osteoarthritis (OA) patients with sarcopenia were statistically lower than those of non-sarcopenic and control group (p <0.01-p<0.001). Body composition parameter results showed that sarcopenic patients had statistically lower values as fat mass, lean body mass and skeletal muscle index (p <0.001, p= 0.001, p <0.001, respectively) than those of non-sarcopenic and control group and fat mass index values (p = 0.012) are lower than the non-sarcopenic group. With respect to sarcopenia, the effect of adiponectin and leptin levels were not detected. It was determined that body composition values measured with DEXA, ultrasonographic measures, isokinetic muscle strength assessment, handgrip strength and gait speed had predictive values for sarcopenia.
Conclusion: We found that patients with sarcopenic OA were older, weaker, undernourished, and restricted in their level of physical activity in the study in which we identified sarcopenia as approximately 12% in patients with osteoarthritis. Among the methods of determining sarcopenia, ultrasound becomes prominent with its practical, cheap and easily accessible features. We think that our results will increase the awareness of the presence of sarcopenia in OA patients.