AB0820 THE RISK OF MALNUTRITION IS A PROBLEM ASSOCIATED WITH SYSTEMIC SCLEROSIS

Abstract

BackgroundMalnutrition is a serious health problem that worsens comorbid processes, increases hospital stays, infections and mortality. In addition, in chronic patients, it increases the complexity of the processes and the fragility of the patient who suffers from it.ObjectivesTo describe the prevalence of malnutrition and malnutrition risk and its associated factors in a series of patients with Systemic Sclerosis (SSc).MethodsDesign:Cross-sectional descriptive study.Participants: consecutive recruitment of patients with SSc (ACR/EULAR 2013 criteria) followed up in our unit. Follow-up of these patients is usually carried out every 3 to 6 months in consultation and all patients were registered in a database. 90% of the patients accepted and signed the consent, the rest refused due to travel or work difficulties.Variables:The main variable was malnutrition or risk of malnutrition defined according to the Mini Nutritional Assessment (MNA) questionnaire, malnutrition was defined with a score less than or equal to 7, risk of malnutrition with scores between 8 and 11, and normal nutrition with values greater than 11. Clinical data, anthropometric and laboratory values were collected, as well as sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOPII) and Short Physical Performance Battery (SPPB) criteria.Statistical analysis:descriptive, bivariate and a multiple linear regression model to identify factors associated with malnutrition and risk of malnutrition.Results52 patients were included, of whom 51 (98.1%) were women, with a mean (SD) age of 60.8 (11.0) years. 17/52 patients (32.7%) were at risk of malnutrition and 1/52 patients (1.9%) were malnourished (Table 1). Patients at risk of malnutrition and malnutrition compared with patients with normal nutritional status, more frequently had diffuse skin involvement (38.9% vs 14.7%; p= 0.05), sarcopenia (44.4% vs 11.8%; p=0.01), severe sarcopenia (27.8 vs 2.9; p=0.01), weight loss (100.0 vs 55.6%; p<0.001) and polypharmacy (94.4% vs. 67.6%, p=0.02). Likewise, patients at risk of malnutrition and malnutrition had lower mean values (SD) in calcium levels (8.7 [2.1] vs 9.2 [0.42]; p=0.05), circumference lesser left calf (32.8 [3.0] vs 35.4 [6.0]; p = 0.03), and in the SPPB functional grade (8.1 [4.2] vs 9.8 [2.9]; p = 0.06) and higher PCR values (10.5 [11.1] vs 7.1 [7.0]; p = 0.06). In multivariate analysis, the only factor associated with malnutrition in SSc was sarcopenia (B [95% CI], -2.521 [-4.867, -0.175]; p=0.036) (R2=0.115).ConclusionMalnutrition has serious consequences for the health of people with SSc, including the development of sarcopenia, a condition that predicts disability, hospitalization, and premature death.Table 1.Clinical-epidemiological characteristics of the 52 patients in SScVariableES n=52Woman, n (%)51 (98,1)Age, mean (SD)60,8 (11,0)Limited skin patern, n (%)40 (76,9)Disseminated skin patern, n (%)12 (23,1)DILD, n (%)17 (32,7)HTAP, n (%)5 (9,6)Anti-Centromere, n (%)28 (53,8)Anti-Sl70, n (%)10 (19,2)Other antibodies, n (%)9 (17,3)MNA Normal nutritional status n (%)34 (64,5)MNA Risk of malnutrition, n (%)17 (32,7)MNA malnutrition, n (%)1 (1,9)Sarcopenia, n (%)12 (23,1)Sarcopenia severe, n (%)6(11,5)Right calf circumference, mean (SD)34,5 (5,5)Left calf circumference, mean(SD)34,5 (5,3)Weight loss >1kg in the last 3 months, n (%)25 (48,1)Polypharmacy, n (%)12 (23,1)CPR mg/dl, mean (SD)8,3 (8,7)Calcium mg/L mean (SD)9 (1,2)Prealbúmin mg/dl, mean (SD)21,4 (4,6)Abreviaturas. SSc: sistemic sclerosis; DE: estandard deviation; DILD: diffuse interstitial lung disease; HTAP: pulmonary arterial hypertension; MNA: mini nutritional assesment; CPR: c reactive protein.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.