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      Assessment of sarcopenia in patients with fibromyalgia

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          Abstract

          Fibromyalgia is a chronic disorder characterized by persistent widespread musculoskeletal pain. Patients with fibromyalgia have reduced physical activity and increased sedentary rate. The age-associated reduction of skeletal muscle mass and function is called sarcopenia. The European Working Group on Sarcopenia in Older People developed a practical clinical definition and consensus diagnostic criteria for sarcopenia. Loss of muscle function is common in fibromyalgia and in the elderly. The goal of this study is to determine whether the reduction of muscle function in fibromyalgia is related to sarcopenia according to the European Working Group on Sarcopenia in Older People criteria. Forty-five patients with fibromyalgia and thirty-nine healthy control female subjects were included. All the participants were assessed by Fibromyalgia Impact Questionnaire and SARC-F questionnaire. Muscle mass was evaluated by bioimpedance analysis, muscle strength by handgrip strength test and physical performance with the Short Physical Performance Battery. Fibromyalgia Impact Questionnaire and SARC-F scores were statistically significantly higher in the fibromyalgia group than in the control group, showing severe disease and a higher risk of sarcopenia in the fibromyalgia group ( p < 0.001). Muscle strength and physical performance were statistically significantly lower in the group with fibromyalgia than in the control group ( p < 0.001). There was no statistical difference between fibromyalgia and control groups regarding skeletal muscle mass ( p = 0.263). Our study demonstrated a significant reduction in muscle function in fibromyalgia patients without any loss of muscle mass. Loss of muscle function without decrease in muscle mass is called dynapenia.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00296-021-04973-6.

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          Most cited references28

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          An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies

          The propensity score is the probability of treatment assignment conditional on observed baseline characteristics. The propensity score allows one to design and analyze an observational (nonrandomized) study so that it mimics some of the particular characteristics of a randomized controlled trial. In particular, the propensity score is a balancing score: conditional on the propensity score, the distribution of observed baseline covariates will be similar between treated and untreated subjects. I describe 4 different propensity score methods: matching on the propensity score, stratification on the propensity score, inverse probability of treatment weighting using the propensity score, and covariate adjustment using the propensity score. I describe balance diagnostics for examining whether the propensity score model has been adequately specified. Furthermore, I discuss differences between regression-based methods and propensity score-based methods for the analysis of observational data. I describe different causal average treatment effects and their relationship with propensity score analyses.
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            Sarcopenia: European consensus on definition and diagnosis

            The European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria for age-related sarcopenia. EWGSOP included representatives from four participant organisations, i.e. the European Geriatric Medicine Society, the European Society for Clinical Nutrition and Metabolism, the International Association of Gerontology and Geriatrics—European Region and the International Association of Nutrition and Aging. These organisations endorsed the findings in the final document. The group met and addressed the following questions, using the medical literature to build evidence-based answers: (i) What is sarcopenia? (ii) What parameters define sarcopenia? (iii) What variables reflect these parameters, and what measurement tools and cut-off points can be used? (iv) How does sarcopenia relate to cachexia, frailty and sarcopenic obesity? For the diagnosis of sarcopenia, EWGSOP recommends using the presence of both low muscle mass + low muscle function (strength or performance). EWGSOP variously applies these characteristics to further define conceptual stages as ‘presarcopenia’, ‘sarcopenia’ and ‘severe sarcopenia’. EWGSOP reviewed a wide range of tools that can be used to measure the specific variables of muscle mass, muscle strength and physical performance. Our paper summarises currently available data defining sarcopenia cut-off points by age and gender; suggests an algorithm for sarcopenia case finding in older individuals based on measurements of gait speed, grip strength and muscle mass; and presents a list of suggested primary and secondary outcome domains for research. Once an operational definition of sarcopenia is adopted and included in the mainstream of comprehensive geriatric assessment, the next steps are to define the natural course of sarcopenia and to develop and define effective treatment.
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              Sarcopenia: revised European consensus on definition and diagnosis

              doi: 10.1093/ageing/afy169 In the original version of the above paper there was an error in Table 3, which shows the recommended cut-off points for ASM/height2 in women. The cut-off point was given as <6.0 kg/m2, but the correct value is <5.5 kg/m2. This has now been corrected online. The authors wish to apologise for this error.
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                Author and article information

                Contributors
                abeline.k@gmail.com
                Journal
                Rheumatol Int
                Rheumatol Int
                Rheumatology International
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0172-8172
                1437-160X
                21 August 2021
                21 August 2021
                2022
                : 42
                : 2
                : 279-284
                Affiliations
                [1 ]GRID grid.412157.4, ISNI 0000 0000 8571 829X, Department of Rheumatology, , Hôpital Erasme, Université Libre de Bruxelles, ; 808, Route de Lennik, 1070 Bruxelles, Belgium
                [2 ]GRID grid.412157.4, ISNI 0000 0000 8571 829X, Department of Geriatrics, , Hôpital Erasme, Université Libre de Bruxelles, ; Bruxelles, Belgium
                Author information
                http://orcid.org/0000-0001-7477-1543
                Article
                4973
                10.1007/s00296-021-04973-6
                8800887
                34417829
                b91b028c-1680-4621-8c89-69dcdbf3ae35
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 22 June 2021
                : 14 August 2021
                Categories
                Observational Research
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2022

                Rheumatology
                fibromyalgia,muscle mass,muscle strength,physical performance,sarcopenia
                Rheumatology
                fibromyalgia, muscle mass, muscle strength, physical performance, sarcopenia

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