Assessing Sarcopenia, Presarcopenia, and Malnutrition in Axial Spondyloarthritis: Insights from a Spanish Cohort.

BACKGROUND/

OBJECTIVES

Sarcopenia, defined by a loss of muscle mass, strength, and function, is a potential comorbidity in axial spondyloarthritis (axSpA). Its prevalence, along with malnutrition, remains unclear.

METHODS

This cross-sectional study assessed sarcopenia (using the European Working Group on Sarcopenia in Older People (EWGSOP-2) criteria), presarcopenia, and malnutrition (using the Global Leadership Initiative on Malnutrition (GLIM) criteria) in a Spanish axSpA cohort. We included 94 patients aged ≥ 50 years. Sarcopenia was evaluated using the SARC-F questionnaire and by measuring muscle strength, mass, and performance. Presarcopenia was defined as low muscle mass alone. Malnutrition was assessed using body mass index (BMI) and fat-free mass index (FFMI).

RESULTS

The prevalence of sarcopenia, presarcopenia, and malnutrition was 3.2%, 23.4%, and 10.6%, respectively. Sarcopenia correlated with worse functionality and quality of life (Bath Ankylosing Spondylitis Functional Index (BASFI) 7.6 ± 1.2 vs. 3.6 ± 2.5, p = 0.02; ASAS Health Index (ASAS-HI) 11 ± 2 vs. 5.6 ± 3.7, p = 0.03). Presarcopenia was linked to a lower BMI (24.7 ± 4.1 vs. 29.1 ± 4.2, p < 0.01), FFMI (16.1 ± 2 vs. 19.6 ± 2.6, p < 0.01), and reduced biologic treatment use (31.8% vs. 61.1%, p = 0.03). Malnourished patients had lower muscle mass (5.14 ± 0.73 vs. 6.23 ± 0.96, p < 0.01). SARC-F showed 100% sensitivity and 75.8% specificity for sarcopenia detection.

CONCLUSIONS

Despite low sarcopenia prevalence, presarcopenia and malnutrition are frequent, highlighting the need for early detection in axSpA.