High prevalence of serum zinc and copper deficiencies in systemic sclerosis: a cross-sectional study

The prevalence of malnutrition in patients with Systemic Sclerosis (SSc) is significant and adversely affects disease progression. This study aimed to investigate the nutritional status of patients with SSc and the relationship between micronutrients and nutritional status. This cross-sectional observational study included 50 patients with SSc. We measured levels of vitamins (A, B1, B6, B12, D, folic acid), trace elements (copper, zinc, selenium, chromium), and proteins (prealbumin, ceruloplasmin). ICP-MS was used for trace element analysis. The relationships between outcomes, patients' demographic characteristics, and nutritional status were assessed. Malnutrition was found in 48% of patients (46% moderate, 2% severe). Patients with diffuse SSc (dcSSc) had a significantly higher risk of moderate malnutrition than those with limited SSc (lcSSc) (70% vs. 30%, p = 0.004). Copper and zinc deficiencies were nearly universal, affecting 96% and 98% of patients, respectively. Median copper (12.9 vs 22.5 μg/dL, p = 0.022) and zinc (11.1 vs 18.4 μg/dL, p = 0.013) levels were significantly lower in the dcSSc group compared to lcSSc. Vitamin D deficiency was prevalent in 72% of the cohort. In our cohort, malnutrition was notably prevalent, particularly among patients with dcSSc. The observed high rates of zinc, copper, and vitamin D deficiencies point toward a need for heightened clinical vigilance. While further large-scale studies are required to confirm these trends, periodic screening of these micronutrients may play a supportive role in optimizing the nutritional status of SSc patients.