The association between CONUT score, mRSS, and development of digital ulcers in SSc patients

Abstract

Objective: Digital ulcers (DUs) are a common manifestation of digital vascular damage in patients with Systemic Sclerosis (SSc), with more than half of SSc patients experiencing DUs at some point in their lives. Currently, there is a need for biomarkers related to inflammation or vascular damage that can predict the development of DUs. Methods: In this cross-sectional study, we included 42 patients with diffuse (n=26) and limited cutaneous (n=16) SSc. All patients were followed for one year to monitor the occurrence of DUs. DUs occurred at least once in 20 patients, while 22 patients never developed DUs. Patient characteristics and baseline CONUT scores were compared between SSc patients with and without DUs. Data were analyzed using the SPSS 25.0 software (IBM SPSS Statistics 25, Armonk, NY: IBM Corp.). Continuous variables were presented as mean ± standard deviation, and the Independent samples t-test was used for parametric test assumptions, while the Mann-Whitney U test was used for non-parametric test assumptions to compare independent groups. The difference between categorical variables was analyzed using Chi-Square analysis. Statistical significance was set at P<0.05. Results: The average age of the study group was 50.29 ± 13.9 years, and the disease duration was 9.31 ± 7.11 years. There were no significant differences in terms of age, disease duration, body mass index, serum levels of albumin and vitamin D, lipid panels, and inflammatory indexes (NLR, PLR) between SSc patients with and without digital ulcers (p>0.05 for all). The CONUT score was 0.86 ± 1.49 in patients without DUs and 1.2 ± 1.01 in patients with DUs (p: 0.092). The baseline modified Rodnan skin score (mRSS) was significantly higher in SSc patients with DUs. Conclusion: The baseline CONUT score was not significantly different in SSc patients with and without DUs. However, a higher mRSS was positively correlated with an increased risk of developing DUs in SSc patients.