Frequency and implications of malnutrition in systemic sclerosis

Area of Science:

• Rheumatology
• Clinical Nutrition
• Scleroderma Research

Background:

• Systemic sclerosis (SSc) is a complex autoimmune disease.
• Malnutrition is a recognized complication in chronic diseases.
• The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized diagnostic framework.

Purpose of the Study:

• To determine the prevalence of malnutrition in SSc using GLIM criteria.
• To assess the impact of malnutrition on survival, quality of life, and physical function in SSc patients.

Main Methods:

• Analysis of data from the Australian Scleroderma Cohort Study.
• Inclusion of SSc patients meeting ACR/EULAR criteria with weight and height measurements.
• Application of GLIM criteria (weight loss, BMI, muscle atrophy) for malnutrition diagnosis.
• Statistical analyses including logistic regression and survival models (Kaplan-Meier, Cox proportional hazards).

Main Results:

• 43% of 1903 SSc participants were diagnosed with malnutrition, 33% severely.
• Malnourished patients were older, more likely to have diffuse cutaneous SSc, and higher disease severity.
• Gastrointestinal involvement, multimorbidity, pulmonary arterial hypertension, and upper GI symptoms were associated with malnutrition.
• Poorer health-related quality of life and physical function were observed in malnourished individuals.
• Malnutrition was independently associated with worse survival (HR 1.4).

Conclusions:

• Malnutrition is a frequent and significant issue in systemic sclerosis.
• GLIM criteria effectively identify malnutrition in SSc.
• Malnutrition is linked to adverse outcomes, including reduced survival and impaired physical function and quality of life.