The impact of malnutrition on quality of life in patients with systemic sclerosis

Preis, Emelina; Franz, K.; Siegert, Elise; Makowka, Alexander; March, Christine; Riemekasten, Gabriela; Cereda, Emanuele; Norman, Kristina

doi:10.1038/s41430-018-0116-z

Cited by 28 publications

(18 citation statements)

References 25 publications

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“…1 GI in-volvement may lead to malnutrition, which can significantly reduce quality of life and influence both morbidity and mortality of SSc patients. 2 Malnutrition in SSc is associated with disease severity. Disability of hands due to digital ulcers (DUs) and sclerodactyly, making meal preparation and consumption difficult, should also be considered among the factors that negatively impact the nutrition status of SSc patients.…”

Section: Introductionmentioning

confidence: 99%

“…Symptoms related to GIT involvement, including nausea, vomiting, constipation, gastroesophageal reflux, diarrhea, and weight loss, are present in >90% of SSc patients 1 . GI involvement may lead to malnutrition, which can significantly reduce quality of life and influence both morbidity and mortality of SSc patients 2 . Malnutrition in SSc is associated with disease severity.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria

Rosato

Gigante

Gasperini

et al. 2020

J Parenter Enteral Nutr

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Background Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs. Gastrointestinal tract (GIT) involvement may lead to malnutrition, which can in turn negatively affect morbidity, mortality, and quality of life. The aim of the study was to assess the prevalence of malnutrition in SSc patients with both the European Society of Clinical Nutrition and Metabolism (ESPEN) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and to assess whether it relates with disease activity and severity. Methods Adult SSc patients were included in the study. Biochemical analyses, disease activity index (DAI), disease severity scale (DSS), anthropometric data, and body composition parameters for GLIM and ESPEN assessment were recorded at enrollment. Results One hundred and two SSc patients were enrolled (86 females, mean age 55 ± 14 years). The prevalence of malnutrition was 8.8% (9 of 102), according to ESPEN, and 16.6% (17 of 102), according to GLIM criteria. GLIM severity grading of malnutrition was moderate in 12.7% (13 of 102) and severe in 3.9% (4 of 102) . In SSc patients with malnutrition according to GLIM criteria, DAI and DSS were significantly higher than in SSc patients without malnutrition (P < .0001), whereas no association was observed between malnutrition and DAI or DSS when using the ESPEN criteria. Conclusion Prevalence of malnutrition is higher with GLIM than with ESPEN criteria. Irrespective of the method used, prevalence of malnutrition in SSc is lower than one would expect in a chronic, autoimmune disease with GIT involvement.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria

Rosato

Gigante

Gasperini

et al. 2020

J Parenter Enteral Nutr

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“…This observation, if confirmed by additional studies, may be useful to better diagnose and potentially treat body composition modifications during scleroderma, considering that, unlike nutrition screening and evaluation, 24 echocardiograpy is routinely performed in the assessment and follow‐up of SSc patients.…”

Section: Discussionmentioning

confidence: 69%

Left Ventricular Mass Index as Potential Surrogate of Muscularity in Patients With Systemic Sclerosis Without Cardiovascular Disease

Molfino

Gasperini

Gigante

et al. 2020

J Parenter Enteral Nutr

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Background Systemic sclerosis (SSc) may be associated with protein‐energy malnutrition. It was demonstrated that left ventricular mass (LVM) reflected poor nutrition status in SSc patients, and no data are available on LVM as a surrogate measure of muscularity. We aimed to evaluate, in SSc patients, the relationship between muscle mass and LVM as a novel indicator of muscularity in this setting. Methods SSc patients and healthy controls (HCs) were considered and underwent echocardiography to assess LVM and LVM index (LVMI). Body composition, including fat‐free mass index (FFMI), phase angle (PhA), and body cell mass index (BCMI), was analyzed by multifrequency bioelectrical impedance analysis. Results Sixty‐four SSc patients (aged 51 ± 13 years) and 30 HCs (aged 46 ± 13 years) were enrolled. BCMI and PhA were lower in SSc patients compared with HCs (P < .001). LVM and LVMI were not different between SSc patients and HCs (P = .068, P = .14, respectively). In SSc patients, a significant correlation was shown between LVMI and FFMI (τ = 0.192, P = .026); in multiple regression analysis, FFMI was significantly associated with the Malnutrition Universal Screening Tool (P < .0001), LVMI (P = .01), and disease severity scale (P = .02). Conclusion Changes in body composition were present in SSc patients, particularly in terms of BMCI and PhA. A correlation between LVMI and FFMI as indexes of muscularity exists in this cohort, suggesting that cardiac mass might be used as a surrogate of nutrition status in this setting.

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“…50 Furthermore, patients with SIBO have higher levels of fecal calprotectin (a bowel inflammatory marker). 50 Approximately 10% of SSc patients can develop malnutrition, 51 with lower levels of serum albumin and vitamin B12 and reduced quality of life. 49,51 Regarding the microbiota composition in SSc and SIBO patients, a study published in 2019 reported an abundance of Odoribacter, Bilophila and Lachnospira species, finding…”

Section: Microbiota Changes In the Lower Digestive Tractmentioning

confidence: 99%

Digestive Dysbiosis in Systemic Scleroderma: a Review

Bratoiu

Burlui

Richter

et al. 2021

Journal of Interdisciplinary Medicine

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Systemic sclerosis (SSc) is a rare autoimmune disease characterized by widespread microvasculopathy, inflammation, and fibrosis of the skin and internal organs. The involvement of the gastrointestinal tract is associated with a wide variety of symptoms and affects circa 90% of patients during the course of the disease. The gastrointestinal microbiota contains trillions of microbial cells and has been found to contribute to both local and systemic homeostasis. In both health and disease, a dynamic interrelationship between gut microbiome activity and the host immune system has been identified. Gastrointestinal dysbiosis has been described as having an important role in obesity, diabetes mellitus, liver disease, cardiovascular and neuropsychiatric disorders, neoplasia, as well as autoimmunity. Recent scientific data indicates a notable role of dysbiosis in the pathogenesis of SSc-related digestive involvement together with various other clinical manifestations. The present review aims to summarize the recent findings regarding digestive dysbiosis as well as the relationship between gastrointestinal microbiota and certain features of SSc.

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The impact of malnutrition on quality of life in patients with systemic sclerosis

Cited by 28 publications

References 25 publications

Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria

Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria

Left Ventricular Mass Index as Potential Surrogate of Muscularity in Patients With Systemic Sclerosis Without Cardiovascular Disease

Digestive Dysbiosis in Systemic Scleroderma: a Review

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