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Prevalence of malnutrition in systemic sclerosis patients assessed by different diagnostic tools

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Abstract

Gastrointestinal complaints of scleroderma (SS) patients are risk factors for impaired nutritional status, so insightful assessment is necessary. The aim was comparison of malnutrition rates in SS patients using different tools. Nutritional status was assessed using 7-SGA and SNAQ in 56 patients (47F, 9M) with SS. Anthropometric measurements and analysis of body composition were done. Serum levels of CRP, albumin, and hemoglobin were determined. Retrospectively, in 2018, diagnosis of malnutrition was verified using ESPEN 2015 and GLIM 2018 criteria. Gastrointestinal complaints were present in 76.8% of respondents. BMI < 18.5 was found in only 5.4% subjects. However, the percentage of patients with impaired nutritional status was higher and varied, depending on the tools used: 16.1% in SNAQ, 17.9% according to ESPEN 2015, 23.2% in 7-SGA, and as high as 62.5% when GLIM criteria were used. A significant part of patients with SS is malnourished. Screening for malnutrition should be focused on the percentage of unintentional weight loss, presence of gastrointestinal symptoms, and analysis of body composition. The choice of diagnostic tool appropriate for patients with SS will enable starting on-time nutritional intervention.

Key Points:

• Gastrointestinal involvement causes a significant proportion of patients to be malnourished.

• It is important to look for early signs of malnutrition in patients with SS.

• Assessment of nutritional status by adequate tools enables starting on-time nutritional intervention and improving prognosis in SS patients.

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Abbreviations

7-SGA:

Subjective Global Assessment (1-7 points)

ACR:

American College of Rheumatology

ALB:

Albumin

BMI:

Body mass index

CRP:

C-reactive protein

CSRGR:

Canadian Scleroderma Research Group Registry

dSS:

Diffuse form of systemic sclerosis

ECW:

Extracellular water

ESPEN:

European Society for Parenteral and Enteral Nutrition

EULAR:

European League Against Rheumatism

FAT%:

Percentage of fat tissue

FFMI:

Fat-free mass index

FTI:

Fat tissue index

GLIM:

Global Leadership Initiative on Malnutrition

HGS:

Handgrip strength

ICW:

Intracellular water

lSS:

Limited form of systemic sclerosis

MAC:

Mid-arm circumference

MUST:

Malnutrition Universal Screening Tool

SNAQ:

Short Nutritional Assessment Questionnaire

SS:

Systemic sclerosis

TBW:

Total body water

TSF:

Triceps skinfold thickness

UBML:

Unintentional body mass loss

WC:

Waist circumference

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Authors and Affiliations

  1. Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Dębinki St. 7, 80-211, Gdańsk, Poland

    Anna Wojteczek & Zbigniew Zdrojewski

  2. Department of Clinical Nutrition and Dietetics, Medical University of Gdańsk, Dębinki St. 7, 80-211, Gdańsk, Poland

    Jolanta A. Dardzińska & Sylwia Małgorzewicz

  3. Department of Radiology Informatics and Statistics, Medical University of Gdańsk, Dębinki St. 7, 80-211, Gdańsk, Poland

    Agnieszka Gruszecka

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  1. Anna Wojteczek
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  2. Jolanta A. Dardzińska
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  3. Sylwia Małgorzewicz
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  5. Zbigniew Zdrojewski
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Correspondence to Jolanta A. Dardzińska.

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Wojteczek, A., Dardzińska, J.A., Małgorzewicz, S. et al. Prevalence of malnutrition in systemic sclerosis patients assessed by different diagnostic tools. Clin Rheumatol 39, 227–232 (2020). https://doi.org/10.1007/s10067-019-04810-z

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  • DOI: https://doi.org/10.1007/s10067-019-04810-z

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