Abstracts of the 9 th International Conference on Cachexia, Sarcopenia, and Muscle Wasting, Berlin, Germany, 10–11 December 2016 (part 2)

s of the 9th International Conference on Cachexia, Sarcopenia, and Muscle Wasting, Berlin, Germany, 10–11 December 2016 (part 2) 1-39 A review of body composition, bone mineral density, and anthropometry in a cohort of 2521 women presenting for bone mineral density testing in a tertiary centre Boyd J. G. Strauss, Ming Li Yee & Christopher Gilfillan Department of Medicine, School of Clinical Sciences, Monash University Clayton, Victoria, Australia; Endocrinology Department Eastern Clinical School, Eastern Health, Melbourne, Victoria, Australia Background: Sarcopenia is defined as loss of skeletal muscle mass and function. In clinical research, measurement of skeletal muscle mass index (SMI) is based on appendicular skeletal muscle mass (kg)/height 2 (m) <2 SD below the mean of a young reference group. SMI was found to be associated with increased physical disability independent of age, ethnicity, comorbidity, and fat mass. Alternatively, SMI is reported as weight-adjusted SMI derived from values obtained from bioelectrical impedance analysis. A recent study suggests the height-adjusted SMI has better correlation with reduced muscle strength and gait speed. Methods: We assessed data on 2521 women with a variety of medical conditions who presented to a tertiary hospital for assessment of bone mineral density (BMD). Some of these women also had concurrent body composition and anthropometry performed. Aims: We aim (i) To determine the relationship between BMD, body composition, and anthropometry in the whole group and subgroups. (ii) To determine The relationship between age and decline in skeletal muscle mass and its relationship to anthropometric variables. (iii) To explore leg length (which appears constant with age) vs. height (which declines with age) in standardizing skeletal muscle measurement for body size. Results: Participants were females aged 40–97 years (mean 59 years). The majority of the patients who were referred presented on a background of breast cancer (n = 679, 27.9%), followed by screening or other causes (n = 563, 22.3%) and steroid use (n = 241, 9.6%). When analysed on regression variable plots, reduction in sitting height, biceps, thigh skin fold, total body, femoral neck BMD, and T score occurs with age. Discussion: There were no changes observed in leg length with age. This suggests that leg length may be used as an alternative to height in the calculation of skeletal muscle mass index. 1. Baumgartner RN, et al Epidemiology of sarcopenia among the elderly in New Mexico, American Journal of Epidemiology 147:8: 755-763 2. Cruz –Jentoft AJ et al, Sarcopenia: European consensus on definition and diagnosis Report of the European Working Group on Sarcopenia in Older People Age and Ageing 2010: 39: 412-423 3. Janssen et al, Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J. Am. Geriatr. Soc. 50, 889–896 (2002) 4. Han DS et al, Skeletal muscle mass adjusted by height correlated better with muscular functions than that adjusted by body weight in defining sarcopenia Scientific Reports 20 January 2016 1-8 1-40 Low muscle mass at initiation of anti-tumour necrosis factor therapy for inflammatory bowel disease is associated with early treatment failure Darcy Quinn Holt, Poornima Varma, Boyd Josef Gimnicher Strauss, Anton S. Rajadurai & Gregory Thomas Moore Department of Gastroenterology and Hepatology, Mon ash Health, Clayton, Victoria, Australia; School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia Goals: We sought to determine whether low muscle mass at commencement of anti-tumour necrosis factor (TNF) therapy was associated with earlier treatment failure. Background: Delayed treatment failure occurs in significant proportion of inflammatory bowel disease (IBD) patients ABSTRACTS © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders Journal of Cachexia, Sarcopenia and Muscle 2017; 8: 161–183 Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/jcsm.12182 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. treated with TNF-alpha antagonists. Identification of predictors of loss of response may help optimize therapy. Study: A retrospective cohort study was performed of 67 patients who had undergone cross-sectional abdominal imaging at a single centre coincident with commencement of anti-TNF drugs. Analysis of the images at the third lumbar vertebra was performed using standard techniques to determine cross-sectional areas of skeletal muscle (SM), visceral adipose tissue, subcutaneous adipose tissue, and intermuscular adipose tissue. Treatment failure was defined as follows: a post-induction hospital admission or surgery for IBD, escalation of TNF dose or immunosuppressants for clinical loss of response, emergence of a new fistula, or rising Crohn’s Disease Activity Index >150. Results: Two-thirds of patients had sarcopenia. Patients with less than the gender-specific median SM area had a median time to failure of 520 (SD 135) days compared with 1100 (SD 151) days for those with greater than median SM area (P = 0.036). No difference was found in disease duration, inflammatory markers, or Crohn’s Disease Activity Index between quartiles of SM area. No relation between outcomes and measures of adipose tissue, weight, or body mass index was observed. Conclusions: Identifying low muscle mass at anti-TNF induction as a risk factor for treatment failure may contribute to a more tailored approach to IBD therapy. 1-41 Cushing’s syndrome: a model for sarcopenic obesity Michael Drey*, Christina M. Berr, Martin Reincke, Julia Fazel, Jochen Seissler, Jochen Schopohl, Martin Bidlingmaier, Stefanie Zopp, Nicole Reisch, Felix Beuschlein, Andrea Osswald & Ralf Schmidmaier Medizinische Klinik und Poliklinik IV, Klinikum der Universität München (LMU), Munich, Germany Background and aims: Obesity and its metabolic impairments are discussed as major risk factors for sarcopenia leading to sarcopenic obesity. Cushing’s syndrome (CS) is known to be associated with obesity and muscle atrophy. The German Cushing Registry prospectively studies phenotypic and biochemical characteristics of CS. We compared CS with matched obese controls (OC) regarding body composition, physical performance, and biochemical markers to test the hypothesis that CS could be a model for sarcopenic obesity. Methods: Analysed were 47 patients with active CS and 108 controls. By propensity score matching, 47 controls were selected by body mass index and gender as OC. Fat mass and muscle mass were measured by bioelectrical impedance analysis. Muscle function was assessed by chair rising test and hand grip strength. Multiple regression analysis was used to investigate differences in body composition, physical performance, and biochemical markers adjusted for gender and age between the groups. Results: Muscle mass did not differ between CS and OC (25.3 kg vs. 25.6 kg, P = 0.793). However, CS patients showed significantly greater chair rising time (9.5 s vs. 7.3 s, P = 0.008) and significantly lower hand grip strength (32.1 kg vs. 36.8 kg, P = 0.003). Furthermore, waist-to-hip ratio (1.0 vs. 0.9, P< 0.001) and HbA1c (6.1% vs. 5.4%, P< 0.001) adjusted for age and gender were higher in CS. CS patients with impaired fasting glucose have shown the highest limitations in hand grip strength (P = 0.025) and chair rising time (P< 0.001). Conclusions: Similar to published data in geriatrics, CS patients show impaired muscle function that cannot be explained by low muscle mass. Impaired muscle quality due to fat infiltration may be the reason. Research in sarcopenic obesity in elderly is hampered by confounding comorbidities and polymedication. As CS patients are frequently free of comorbidities and as CS is potentially curable, we suggest CS as a clinical model for further research in sarcopenic obesity. 1-42 Serum creatinine/cystatin c ratio predicts strongly both sarcopenia and poor prognosis in the elderly Takayuki Tsuneda, Hidehiko Nagasawa, Atsuhiro Shimakura & Masanobu Takata Internal Medicine, Toyama Teishin Hospital, Toyama, Japan Background: Sarcopenia develops poor prognosis in the elderly. Serum creatinine (SCr) is a major biomarker to reflect not only renal functio, but also total mass of muscle. Recently, cystatin C (CysC) is building up a renal marker without any influences of muscle mass and superior to SCr to estimate renal insufficiency. Previous reports show that low value of SCr did not reflect reserved renal function, especially in lean elderly woman with malnutrition. Therefore, we evaluated retrospectively the impact of SCr/CysC ratio for sarcopenia, the activities of daily living (ADLs), and the prognosis. Method: We enrolled 324 patients in our hospital (79 13 years old; men, 46%) and collected SCr, CysC, and albumin. For estimation of sarcopenia, we measured the area of bilateral psoas muscle normalized by height [total psoas index (TPI), mm/m] and the Hounsfield unit average calculation (HUAC, HU) as a marker of muscle density and fatty infiltration, using computed tomography (n = 195). ADL was classified by modified Rankin scale (mRS). We also analysed mortality outcome based on SCr/CysC ratio. Results: Serum creatinine/CysC ratio decreased with aging (P< 0.0001). TPI in female was smaller than that in male (P< 0.0001), without gender difference in HUAC. TPI associated with body weight (R = 0.41), and HUAC did 162 Journal of Cachexia, Sarcopenia and Muscle 2017; 8: 161–183 DOI: 10.1002/jcsm.12182 albumin (R = 0.23) and SCr/CysC ratio (R = 0.23). The lower SCr/CysC ratio was related to the greater score of mRS (P< 0.0001) with decrease