Background Systemic sclerosis (SSc) is a chronic connective tissue disease characterized by involvement of multiple organs. Many clinical aspects, such as gastrointestinal involvement, mood disturbances, functional status, and inflammation, may lead to disease-related malnutrition . The connection between inadequate nutritional status and systemic sclerosis is still not well established. It is important to identify the symptoms of malnutrition, because it is known as a predictor of poor clinical outcome .
Objectives To assess nutritional status in patients with systemic sclerosis.
Methods The study involved fifty-two patients with SSc (44 women and 8 men, mean age 54,3±11,7 year) who were diagnosed according to ACR/EULAR criteria. The assessment of nutritional status was determined by subjective global assessment (SGA), body mass index (BMI) and level of serum albumin. Appetite was assessed by simplified nutritional appetite questionnaire (SNAQ). In all patients hand grip strength and triceps skinfold were established. The C-reactive protein (CRP), lipid profile, and level of haemoglobin/lymphocytes were measured in serum.
Results Inadequate nutritional status was diagnosed in 14 patients (26,9%) with SSc. According to SGA 11 (21,15%) patients had signs of mild malnutrition, while 41 (78,85%) were well-nourished. Considering BMI, 1 patient (1,92%) was underweight, 24 (46,15%) were eutrophic, 21 (40,38%) overweight and 6 (11,54%) obese. Significantly lower BMI had patients with inadequate nutritional status (23,17±4,47 vs. 25,98±3,34; p=0,009). Low level of serum albumin was detected in 5 patients (9,6%) with SSc. Level of serum albumin and appetite were significantly decreased in patients with inadequate nutritional status (p=0,009; p=0,003). No statistical differences were noticed in hand grip strength, triceps skinfold, lipid profile, levels of CRP and haemoglobin/lymphocytes.
Conclusions Malnutrition in systemic sclerosis is still underestimated clinical issue. This study provides useful data about nutritional status of patients with systemic sclerosis. Altered level of albumin and decreased appetite may lead to worsening in nutritional status. Assessment of nutritional status in this group of patients should be performed regularly, because it can be potentially modified.
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Krause L, et al. Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis. Ann Rheum Dis 2010;69:1951–1957.
Disclosure of Interest None declared