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Nutritional profile of patients with chronic inflammatory diseases in the age of biologicals

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Abstract

Tumor necrosis factor alpha (TNFα) has an important role in the body composition of patients with rheumatoid arthritis (RA), Crohn’s disease (CD), and spondyloarthritis (SpA). We aimed to assess the nutritional profile of patients with RA, CD, and SpA undergoing remission with multiple therapies comparing to controls and to analyze the effect of anti-TNFα medications in the nutritional parameters of these patients. One hundred thirty-one patients were included: 44 with RA, 43 with CD, and 44 with SpA. Patients receiving anti-TNFα were compared with those receiving non-biological treatment as well as to controls. Nutritional profile included body mass index (BMI), waist circumference (WC), mid-upper arm circumference, and triceps skinfold measurement. Overweight and obesity were highly prevalent on three assessed groups. In patients with RA, BMI was > 25 kg/m2 in 74.9% patients and 49.2% controls (p < 0.0005); in CD, in 55.7% patients and 41.2% controls (p < 0.0001); and in SpA, in 68.1% patients and 43.5% controls (p < 0.0001). Central obesity was higher in all three disease groups when compared to healthy controls. There was no significant difference on nutritional parameters in patients using or not using anti-TNFα medications, except in patients with SpA, in which biologic therapy was significantly associated with lower BMI and WC, when compared to other therapies. Overweight, obesity, and elevated WC were more prevalent in patients with RA, CD, and SpA undergoing remission when compared to controls despite of used therapy. The use of biologic drugs in patients with SpA was associated with a lower BMI and lower WC.

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Authors and Affiliations

  1. Rheumatology Service, Evangelical University Hospital of Curitiba, Curitiba, PR, Brazil

    Gabriela Piovezani Ramos, Thelma Skare & Renato Nisihara

  2. Gastroenterology Service, Evangelical University Hospital of Curitiba, Curitiba, PR, Brazil

    Thelma Skare

  3. Nutrition Department, Federal University of Paraná, Curitiba, PR, Brazil

    Odery Ramos Junior & Estela Rabito

  4. Nutrition Service, Evangelical University Hospital of Curitiba, Curitiba, PR, Brazil

    Elise O. Tanaami & Alessandra M. Stefani

  5. Department of Medicine, Positivo University, Curitiba, PR, Brazil

    Renato Nisihara

  6. Medicine Department, Evangelical University of Paraná, Rua Padre Agostinho, 2770, Curitiba, 80730-000, Brazil

    Renato Nisihara

Authors
  1. Gabriela Piovezani Ramos
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  2. Thelma Skare
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  3. Odery Ramos Junior
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  4. Estela Rabito
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  5. Elise O. Tanaami
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  6. Alessandra M. Stefani
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  7. Renato Nisihara
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Correspondence to Renato Nisihara.

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This cross-sectional study is approved by the local Committee of Ethics in Research. All participants signed consent and were over 18 years of age.

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Ramos, G.P., Skare, T., Junior, O.R. et al. Nutritional profile of patients with chronic inflammatory diseases in the age of biologicals. Clin Rheumatol 38, 45–51 (2019). https://doi.org/10.1007/s10067-018-4085-3

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  • DOI: https://doi.org/10.1007/s10067-018-4085-3

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