系统性硬化症相关的胃肠道受累和低肌肉量的症状。
Symptoms related to gastrointestinal tract involvement and low muscularity in systemic sclerosis.
机构信息
Department of Translational and Precision Medicine, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
出版信息
Clin Rheumatol. 2022 Jun;41(6):1687-1696. doi: 10.1007/s10067-022-06059-5. Epub 2022 Feb 11.
INTRODUCTION/OBJECTIVES: Gastrointestinal tract (GIT) involvement is frequently observed in systemic sclerosis (SSc) and may lead to nutritional impairment. The aim of the study was to assess the prevalence of symptoms related to GIT involvement and to analyze the possible association between gastrointestinal symptoms and low muscularity in SSc patients.
METHODS
Sixty-nine consecutive patients (60 females, median age 53 (IQR 43-63), body mass index (BMI) 23.2 (IQR 20.9-24.6) kg/m) with diagnosis of SSc admitted to our Scleroderma Unit were enrolled. Clinical status, anthropometric data, and bioelectrical impedance (Inbody 770, USA) analysis-assessed Fat-Free Mass Index (FFMI) were recorded upon enrollment. UCLA questionnaire was used to quantify GIT involvement with seven specific scales.
RESULTS
Mean FFMI was 16.2 kg/m (IQR 15.2-17.6). The median UCLA total score was 0.53 (IQR 0.19-0.89). FFMI showed a significant negative correlation with UCLA total score (r = -0.29, p = 0.016) and UCLA distention/bloating (r = -0.35, p < 0.01). In 16 patients (23.1%), FFMI was reduced and UCLA distention/bloating was significantly higher (p = 0.039) in SSc patients with lower FFMI [1.75 (IQR 0.75-2.12) vs 0.75 (IQR 0.25-1.75)]. At multiple linear regression model, FFMI showed association with UCLA distention/bloating [beta coefficient - 0.315 (95% CI of beta coefficient: -0.591; -0.039), p = 0.026], BMI [beta coefficient 0.259 (95% CI of beta coefficient: 0.163; 0.355), p = 0.001], and disease duration [beta coefficient - 0.033 (95% CI of beta coefficient: -0.059; -0.007), p = 0.015].
CONCLUSIONS
In SSc, low FFMI is associated with symptoms related to GIT involvement, in particular with distension/bloating. Key Points • FFMI is associated with symptoms related to GIT involvement. • Low FFMI is associated with symptoms related to UCLA distention/bloating. • Malnutrition is not associated with symptoms related to GIT involvement.
简介/目的：胃肠道（GIT）受累在系统性硬化症（SSc）中经常观察到，并可能导致营养受损。本研究的目的是评估与 GIT 受累相关的症状的患病率，并分析 SSc 患者胃肠道症状与低肌肉量之间的可能关联。
方法
我们招募了 69 名连续的 SSc 患者（60 名女性，中位年龄 53（IQR 43-63），体重指数（BMI）23.2（IQR 20.9-24.6）kg/m）到我们的硬皮病科。在入组时记录临床状况、人体测量数据和生物电阻抗（美国 Inbody 770）分析评估的去脂体重指数（FFMI）。UCLA 问卷用于通过七个特定量表量化 GIT 受累。
结果
平均 FFMI 为 16.2 kg/m（IQR 15.2-17.6）。UCLA 总分中位数为 0.53（IQR 0.19-0.89）。FFMI 与 UCLA 总分呈显著负相关（r=-0.29，p=0.016）和 UCLA 扩张/膨隆（r=-0.35，p<0.01）。在 16 名患者（23.1%）中，FFMI 降低，UCLA 扩张/膨隆显著更高（p=0.039），FFMI 较低的 SSc 患者[1.75（IQR 0.75-2.12）比 0.75（IQR 0.25-1.75）]。在多元线性回归模型中，FFMI 与 UCLA 扩张/膨隆相关[β系数-0.315（β系数 95%置信区间：-0.591；-0.039），p=0.026]、BMI [β系数 0.259（β系数 95%置信区间：0.163；0.355），p=0.001]和疾病持续时间[β系数-0.033（β系数 95%置信区间：-0.059；-0.007），p=0.015]。
结论
在 SSc 中，低 FFMI 与 GIT 受累相关的症状相关，特别是与扩张/膨隆相关。关键点•FFMI 与 GIT 受累相关的症状相关。•低 FFMI 与 UCLA 扩张/膨隆相关的症状相关。•营养不良与 GIT 受累相关的症状无关。
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