Clinical Rheumatology

, Volume 37, Issue 4, pp 987–997 | Cite as

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

  • C. Caimmi
  • P. Caramaschi
  • A. Venturini
  • E. Bertoldo
  • E. Vantaggiato
  • O. Viapiana
  • M. Ferrari
  • G. Lippi
  • L. Frulloni
  • M. Rossini
Original Article

Abstract

Systemic sclerosis (SSc) is an autoimmune disease which may lead to malnutrition. Previous studies have defined it with different criteria. No thorough evaluations of sarcopenia in SSc are available. The aim of the present study was to assess the prevalence and the potential association of malnutrition and sarcopenia in a large cohort of SSc cases. A total of 141 SSc consecutive outpatients were enrolled. Body composition was analyzed by densitometry. Malnutrition was defined according to recently published ESPEN criteria, whereas sarcopenia was diagnosed in patients with reduced skeletal muscle index. Malnutrition was diagnosed in 9.2% of patients (95% CI, 4.4–14.0%). Malnourished patients had worse gastrointestinal symptoms according to UCLA SCTC GIT 2.0 questionnaire (p = 0.007), lower physical activity (p = 0.028), longer disease duration (p = 0.019), worse predicted DLCO/VA and FVC (p = 0.009, respectively), worse disease severity according to Medsger severity score (p < 0.001), lower hemoglobin (p = 0.023), and fat-free mass (p < 0.001) and were more often sarcopenic (p < 0.001). In multivariate analysis, only FVC (p = 0.006) and disease severity (p = 0.003), in particular for the lungs (p = 0.013), were confirmed to be worse in malnourished patients. Sarcopenia was diagnosed in 29\140 patients (20.7%; 95% CI, 14.0–27.4%); 11\29 were also malnourished. In multivariate analysis, sarcopenic patients had longer disease duration (p = 0.049), worse DLCO/VA (p = 0.002), and lung (p = 0.006) and skin (p = 0.014) involvement. In SSc, malnutrition defined with ESPEN criteria was found to be lower than previously reported. Sarcopenia was found to be somewhat common. Lung involvement was significantly associated with nutritional status and may not be explained only by muscle weakness.

Keywords

Lung involvement Malnutrition Sarcopenia Systemic sclerosis 

Notes

Compliance with ethical standards

The study was performed according to the Helsinki declaration and approved by Verona Medical School Institutional review board, with protocol number 18493. All patients provided written informed consent for participating the study.

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • C. Caimmi
    • 1
  • P. Caramaschi
    • 1
  • A. Venturini
    • 1
  • E. Bertoldo
    • 1
  • E. Vantaggiato
    • 1
  • O. Viapiana
    • 1
  • M. Ferrari
    • 2
  • G. Lippi
    • 3
  • L. Frulloni
    • 4
  • M. Rossini
    • 1
  1. 1.Rheumatology UnitUniversity of VeronaVeronaItaly
  2. 2.Respiratory Physiopathology UnitUniversity of VeronaVeronaItaly
  3. 3.Section of Clinical BiochemistryUniversity of VeronaVeronaItaly
  4. 4.Gastroenterology UnitUniversity of VeronaVeronaItaly

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