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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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Does body composition matter in patients with systemic sclerosis?

Chiara Giraudo1, Giulia Fichera1, Marco Binda2

  • 1Unit of Advanced Clinical and Translational Imaging, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, Padova, Italy.

Rheumatology (Oxford, England)
|May 23, 2025
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Summary
This summary is machine-generated.

Body composition significantly impacts scleroderma (SSc) patient outcomes. Myosteatosis and low muscle mass predict mortality, highlighting the need for body composition assessment in SSc management.

Keywords:
CTSScbody compositionimaging

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Area of Science:

  • Rheumatology
  • Pulmonology
  • Radiology
  • Body Composition Analysis

Background:

  • Body composition, including muscle mass and adipose tissue, is increasingly recognized for its role in rheumatic and autoinflammatory diseases.
  • Scleroderma (SSc) is a complex autoimmune condition with significant systemic impact, where body composition factors may influence disease progression and patient outcomes.

Purpose of the Study:

  • To evaluate the impact of muscle mass and subcutaneous adipose tissue quality and quantity on mortality in patients with Systemic Sclerosis (SSc).
  • To identify body composition metrics as predictors of mortality in SSc patients.

Main Methods:

  • Adult SSc patients undergoing high-resolution chest CT (HRCT) were included.
  • Semi-automatic segmentation was used to analyze subcutaneous fat and paravertebral muscle at the 12th dorsal vertebra, quantifying area and density.
  • Stepwise linear regression and odds-risk ratios were employed to assess predictors of mortality, including myosteatosis (muscle fat infiltration).

Main Results:

  • Lower diffusion capacity of the lungs for carbon monoxide (DLCO), higher BMI, increased subcutaneous fat density, and lower skeletal muscle index predicted mortality in SSc patients.
  • A significant portion of SSc patients (72%) exhibited myosteatosis (muscle fat infiltration).
  • Muscle fat infiltration was associated with a 3.345 times higher risk of mortality.

Conclusions:

  • Systemic Sclerosis patients frequently present with myosteatosis and pre-sarcopenia.
  • Body composition parameters, particularly muscle quality and quantity, appear to significantly influence the overall prognosis and survival in SSc.