Malnutrition and sarcopenia in a large cohort of patients with systemic sclerosis

Caimmi, Cristian; Caramaschi, Paola; Venturini, Anna P.; Bertoldo, Eugenia; Vantaggiato, Elisabetta; Viapiana, Ombretta; Ferrari, Marcello; Lippi, Giuseppe; Frulloni, Luca; Rossini, Maurizio

doi:10.1007/s10067-017-3932-y

Cited by 67 publications

(69 citation statements)

References 30 publications

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“…Three studies calculated the prevalence of sarcopenia in systemic sclerosis (SSc). The prevalence was 20.7% when defining sarcopenia using the SMI [ 42 ] and 22.5% in a study from Germany, which included 91.5% females and followed the definition of EWGSOP [ 4 , 43 ]. Another study reported higher prevalence rates of 41.9 and 54.8% applying the SMI and handgrip strength criteria, respectively [ 44 ].…”

Section: Epidemiology Of Sarcopenia In Autoimmune and Rheumatic DImentioning

confidence: 99%

Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Tizaoui

Terrazzino

et al. 2020

IJMS

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Sarcopenia refers to a decrease in skeletal muscle mass and function. Because sarcopenia affects mortality, and causes significant disability, the clinical importance of sarcopenia is emerging. At first, sarcopenia was recognized as an age-related disease but, recently, it has been reported to be prevalent also in younger patients with autoimmune diseases. Specifically, the association of sarcopenia and autoimmune diseases such as rheumatoid arthritis has been studied in detail. Although the pathogenesis of sarcopenia in autoimmune diseases has not been elucidated, chronic inflammation is believed to contribute to sarcopenia, and moreover the pathogenesis seems to be different depending on the respective underlying disease. The definition of sarcopenia differs among studies, which limits direct comparisons. Therefore, in this review, we cover various definitions of sarcopenia used in previous studies and highlight the prevalence of sarcopenia in diverse autoimmune diseases including rheumatoid arthritis, spondyloarthritis, systemic sclerosis, inflammatory bowel disease, and autoimmune diabetes. In addition, we cover the pathogenesis and treatment of sarcopenia in autoimmune and rheumatic diseases. This review provides a comprehensive understanding of sarcopenia in various autoimmune diseases and highlights the need for a consistent definition of sarcopenia.

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Section: Epidemiology Of Sarcopenia In Autoimmune and Rheumatic DImentioning

confidence: 99%

Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Tizaoui

Terrazzino

et al. 2020

IJMS

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“…Unfortunately, all these studies are not longitudinal, so a definite conclusion cannot be drawn. In addition, there are some concerns on the efficacy of vitamin D supplementation given, for instance, the quite high prevalence of malnutrition in SSc patients …”

Section: Introductionmentioning

confidence: 99%

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

et al. 2019

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Aim: Low levels of vitamin D (25OHD) have been found to associated with digital ulcers (DUs) in systemic sclerosis (SSc), although only cross-sectional studies have been performed. We aimed to investigate if variations in vitamin D serum levels over time affect DU in SSc. Methods: This is a retrospective study on 65 patients. 25OHD was measured in 2011 and 2016 and its variations correlated with DU. Results: The mean age of our cohort was 58 (SD 12) years with a mean disease duration of 9.5 (5.3) years. Most of our patients had a limited SSc (69.2%). At baseline 50.8% and 41.5% after 5 years had 25OHD <30 ng/mL. Patients receiving supplementation (8750 IU/wk) at baseline numbered 39 (60.0%) and 45 (69.2%) at the end of follow up. Nevertheless, 31 (47.7%) had a decrease of 25OHD in 5 years. In univariate analysis, patients with incident DU had a decrease in 25OHD as compared to patients with no incident DU (−17.4 [37.0] vs 13.0 [89.5], P = 0.018). No differences in 25OHD variations were found for other disease characteristics. In multivariate analysis correcting for previous DU and modified Rodnan Skin Score at baseline, patients with a decrease in 25OHD had an increased risk of developing DU (odds ratio 16.6;95% CI 1.7-164.5, P = 0.017). Conclusions:A decrease in 25OHD is associated with the risk of developing DUs. In addition, vitamin D supplementation with the doses currently recommended may be insufficient in SSc. Further studies in wider cohorts are needed to confirm these results. K E Y W O R D Sdigital ulcers, supplementation, systemic sclerosis, vitamin D

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“…Other severe gastrointestinal manifestations, including pseudo-obstruction, intestinal dysmotility disorders, volvulus, and intestinal telangiectasia, may signal higher mortality risk and potentially increase the perioperative risk profile [ 45 , 46 ]. Gastrointestinal manifestations may also indicate the presence of malnutrition (20% of patients), sarcopenia, vitamin C deficiency, and worsening lung disease [ 47 , 48 ]. SSc-related primary biliary cirrhosis (PBC) has been shown to occur in 2–22%, but is associated with improved outcomes compared with other forms of PBC [ 49 , 50 ].…”

Section: Preoperative Considerationsmentioning

confidence: 99%

An Update on Systemic Sclerosis and its Perioperative Management

Carr

Klick

McDowell

et al. 2020

Curr Anesthesiol Rep

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Purpose of Review Systemic sclerosis or scleroderma (SSc) is a systemic, immune-mediated disease characterized by abnormal cutaneous and organ-based fibrosis that results in progressive end-organ dysfunction and decreased survival. SSc results in significant challenges for the practicing anesthesiologist due to its rarity, multi-system involvement, and limited evidence-based guidance for optimal perioperative care. In this update, we briefly discuss the recent evidence on the pathophysiology and current management of SSc, review the anesthesia-related literature, and extrapolate these observations into an optimal perioperative strategy for the care of SSc patients. Recent Findings Evidence shows that patients with SSc demonstrate an increased risk for perioperative myocardial infarction, high rates of interstitial lung disease, pulmonary arterial hypertension, neurological disease, gastric dysmotility disorders, and challenging airway management, all findings that may result in suboptimal perioperative outcomes. Summary Advances in SSc medical management have resulted in improved survival, likely increasing the number of patients who will be exposed to perioperative care. Optimal perioperative management and risk stratification should expand beyond the well-described airway challenges and consider numerous systemic manifestations of systemic sclerosis such as pulmonary arterial hypertension, interstitial lung disease, and cardiac sequelae.

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Malnutrition and sarcopenia in a large cohort of patients with systemic sclerosis

Cited by 67 publications

References 30 publications

Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Vitamin D serum levels and the risk of digital ulcers in systemic sclerosis: A longitudinal study

An Update on Systemic Sclerosis and its Perioperative Management

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