Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis
Nutritional status as marker for disease activity and severity predicting mortality in patients with systemic sclerosis
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DOI：
10.1136/ard.2009.123273
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发表时间：
2010-11-01
影响因子：
27.4
通讯作者：
Riemekasten, Gabriela
中科院分区：
文献类型：
--
作者：
Krause, Lijana;Becker, Mike O.;Riemekasten, Gabriela
目的评价系统性硬化症（SSc）患者的营养状况，探讨SSc患者营养状况与临床症状的关系，并探讨SSc患者营养状况对预后的影响。在一项横断面研究中，将SSc患者的BMI和BIA值与临床症状进行比较。在一个前瞻性的开放分析，生存和营养状况和营养治疗引起的能量摄取的变化进行了evaluated.Results与SSc患者有减少相位角（PhA）值，体细胞质量（ESTA），细胞百分比，增加细胞外质量（ECM）和ECM/ESTA值相比，健康供体。PhA值最能反映营养不良。在SSc患者中，69例（55.7%）患有与严重疾病和活动相关的营养不良。通过多变量分析评估，较低的预测用力肺活量和较高的N-末端（NT）-proBNP值最能区分良好和不良的营养状况。在不同的临床参数中，低PhA值是SSC相关死亡率的最佳预测因子。BMI值与疾病症状或死亡率无关。50%的SSc患者与其能量需求相关的能量摄取较低，19.8%与其基础代谢相关。结论营养不良在SSc患者中较为常见，且不能通过BMI来鉴别。BIA参数反映疾病的严重程度，并为患者生存提供最佳预测因子。因此，应在SSc患者中进行营养状况评估。
Objective To assess and analyse nutritional status in patients with systemic sclerosis (SSc) and identify possible associations with clinical symptoms and its prognostic value.Methods Body mass index (BMI) and parameters of bioelectrical impedance analysis (BIA) were assessed in 124 patients with SSc and 295 healthy donors and matched for sex, age and BMI for comparisons. In patients with SSc, BMI and BIA values were compared with clinical symptoms in a cross-sectional study. In a prospective open analysis, survival and changes in the nutritional status and energy uptake induced by nutritional treatment were evaluated.Results Patients with SSc had reduced phase angle (PhA) values, body cell mass (BCM), percentages of cells, increased extracellular mass (ECM) and ECM/BCM values compared with healthy donors. Malnutrition was best reflected by the PhA values. Of the patients with SSc, 69 (55.7%) had malnutrition that was associated with severe disease and activity. As assessed by multivariate analysis, low predicted forced vital capacity and high N-terminal(NT)-proBNP values discriminated best between good and bad nutritional status. Among different clinical parameters, low PhA values were the best predictors for SSc-related mortality. BMI values were not related to disease symptoms or mortality. Fifty per cent of patients with SSc had a lower energy uptake related to their energy requirement, 19.8% related to their basal metabolism. Nutritional treatment improved the patients' nutritional status.Conclusions In patients with SSc, malnutrition is common and not identified by BMI. BIA parameters reflect disease severity and provide best predictors for patient survival. Therefore, an assessment of nutritional status should be performed in patients with SSc.