Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland.
Department of Clinical Nutrition, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland.
Nutrients. 2024 Aug 9;16(16):2622. doi: 10.3390/nu16162622.
(1) Background: Impaired nutritional status in systemic sclerosis (SSc) is prevalent. (2) Objective: This study aimed to identify pre-cachexia and malnutrition in SSc patients and to estimate the effectiveness of a high-protein oral nutritional supplement (ONS) in improving their nutritional status. (3) Materials and methods: The SSc population comprised 56 patients and a control group of 49 healthy persons. After a baseline clinical evaluation, bioelectrical impedance analysis (BIA), and laboratory tests, SSc patients were divided into well-nourished, pre-cachectic, and malnourished categories. SSc patients with a nutritional disbalance received a high-protein ONS once daily for 3 months. Patients were reassessed at 3 and 12 months after inclusion in the study. (4) Results: SSc patients, in comparison to the control group, had a significantly lower seven-point SGA value [6(0) vs. 7(1), < 0.001)], lean tissue mass [LTM, 35.1 (10.5) vs. 40.1 (10.10), = 0.008], and lean tissue index [LTI, 13.5 (3) vs. 14.9 (4), = 0.009]. Of the 56 SSc patients, 40 (71.4%) were well nourished, 5 (8.9%) had pre-cachexia, and 11 (19.7%) were malnourished. A high-protein ONS in the pre-cachexia group stabilized the SGA value, anthropometric measurements, and BIA after 3 and 12 months. In malnourished patients, it significantly improved the SGA value [5(0) vs. 6(0), = 0.002], LTI [12.1 (2.1) vs. 12.7 (3.2), = 0.021] and LTM [31.1 (7.7) vs. 35.1 (9.1), = 0.021], and that effect remained stable at 12 months. (5) Conclusion: Malnutrition is a common complication of SSc that can be improved with nutritional intervention.
(1) 背景：系统性硬化症（SSc）患者普遍存在营养状况受损的情况。(2) 目的：本研究旨在确定 SSc 患者是否存在恶病质前期和营养不良，并评估高蛋白口服营养补充剂（ONS）对改善其营养状况的有效性。(3) 材料和方法：SSc 患者人群包括 56 例患者和 49 例健康对照者。在基线临床评估、生物电阻抗分析（BIA）和实验室检查后，将 SSc 患者分为营养良好、恶病质前期和营养不良组。存在营养失衡的 SSc 患者接受高蛋白 ONS 每日一次，持续 3 个月。患者在入组后 3 个月和 12 个月时进行重新评估。(4) 结果：与对照组相比，SSc 患者的七点简易营养评估量表（SGA）评分明显较低[6(0) 与 7(1)， < 0.001)]，瘦组织量[LTM，35.1(10.5) 与 40.1(10.10)， = 0.008]和瘦组织指数[LTI，13.5(3) 与 14.9(4)， = 0.009]也明显较低。56 例 SSc 患者中，40 例（71.4%）营养良好，5 例（8.9%）存在恶病质前期，11 例（19.7%）营养不良。高蛋白 ONS 可稳定恶病质前期患者的 SGA 值、人体测量学指标和 BIA 3 个月和 12 个月后的结果。在营养不良患者中，ONS 显著改善了 SGA 值[5(0) 与 6(0)， = 0.002]、LTI[12.1(2.1) 与 12.7(3.2)， = 0.021]和 LTM[31.1(7.7) 与 35.1(9.1)， = 0.021]，这种效果在 12 个月时仍保持稳定。(5) 结论：营养不良是 SSc 的常见并发症，通过营养干预可以改善。
