Assessing Malnutrition in Systemic Sclerosis With Global Leadership Initiative on Malnutrition and European Society of Clinical Nutrition and Metabolism Criteria

Abstract Background Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis of the skin and internal organs. Gastrointestinal tract (GIT) involvement may lead to malnutrition, which can in turn negatively affect morbidity, mortality, and quality of life. The aim of the study was to assess the prevalence of malnutrition in SSc patients with both the European Society of Clinical Nutrition and Metabolism (ESPEN) and the Global Leadership Initiative on Malnutrition (GLIM) criteria and to assess whether it relates with disease activity and severity. Methods Adult SSc patients were included in the study. Biochemical analyses, disease activity index (DAI), disease severity scale (DSS), anthropometric data, and body composition parameters for GLIM and ESPEN assessment were recorded at enrollment. Results One hundred and two SSc patients were enrolled (86 females, mean age 55 ± 14 years). The prevalence of malnutrition was 8.8% (9 of 102), according to ESPEN, and 16.6% (17 of 102), according to GLIM criteria. GLIM severity grading of malnutrition was moderate in 12.7% (13 of 102) and severe in 3.9% (4 of 102) . In SSc patients with malnutrition according to GLIM criteria, DAI and DSS were significantly higher than in SSc patients without malnutrition ( P < .0001), whereas no association was observed between malnutrition and DAI or DSS when using the ESPEN criteria. Conclusion Prevalence of malnutrition is higher with GLIM than with ESPEN criteria. Irrespective of the method used, prevalence of malnutrition in SSc is lower than one would expect in a chronic, autoimmune disease with GIT involvement.