POS0479 THE PROGNOSTIC INFLAMMATORY AND NUTRITIONAL INDEX (PINI) IN ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

BackgroundMalnutrition and inflammation are closely related in rheumatoid arthritis (RA). The Prognostic Inflammatory and Nutritional Index (PINI) is a tool assessing the risk of malnutrition-related complications. It combines the determination of two inflammatory and two nutritional proteins.ObjectivesThe aim of our study was to calculate the PINI in elderly patients with RA and to determine its relationship with the disease parameters.MethodsThis is a cross-sectional study including patients aged 65 years or older and followed for RA. Disease activity was assessed using the DAS28 score. Functional impact was measured using the HAQ score. Nutritional status was assessed using the Mini-Nutritional Assessment (MNA). The PINI was calculated as follows:Orosomucoid (g/L) × CRP (mg/L)/ albumin (g/L) × prealbumin (mg/L).ResultsForty patients were enrolled. There were 33 women (82.5%) and 7 men (17.5%). The mean age was 68.37±4.70 years [65-82]. The median duration of disease progression was 11 years with an IQR of [2.45-16.5]. The mean DAS28 was 3.57±1.32 [1.5-6.8]. The mean HAQ score was 1.5±0.53 [0.37-2.6]. The mean MNA score was 20.25±4.5 [8-27.5]. According to the MNA, 22 patients (55%) were at risk of developing undernutrition and 10 patients (25%) were malnourished. The median PINI was 1.77 with an IQR of [0.47-10.21] and extremes ranging from 0.05 to 222.16. Patients were stratified according to PINI score as follows: 13 patients (32.5%) had a normal PINI of less than 1, while 27 patients (67.5%) had a PINI ≥ 1, indicating a risk of undernutrition-related complications. Of these patients with PINI ≥ 1: 18 patients (45%) had a low risk (PINI between 1 and 10), 4 patients (10%) had a moderate risk (PINI between 10 and 20), 2 patients (5%) had a high risk (PINI between 21 and 30) and 3 patients (7.5%) had a life-threatening risk (PINI > 30). Comparison between RA patients with PINI ≥ 1 and PINI < 1 showed a statistically significant difference for acute phase proteins (CRP (p=0.018), haptoglobin (p=0.04)). DAS28 score was significantly higher in the PINI ≥ 1 group (p=0.009), as well as the HAQ score (p=0.004). However, no significant differences were observed concerning the age (p=0.07), gender (p=0.3), duration of the disease (p=0.12), ESR (p=0.7) or MNA (p=0.2).ConclusionIn our study, 67.5% of the patients were at risk of undernutrition-related complications as assessed by the PINI. This tool seems to be interesting for predicting disease activity, functional impairment and inflammation in RA elderly patients.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.