Psoriatic Arthritis (PsA), Rheumatoid Arthritis (RA, Spondyloarthritis (SpA), Systemic Lupus Erythematous (SLE), Systemic Sclerosis (SSc)
Conditions
Keywords
nutritional status, rheumatic diseases, disease activity
Brief summary
The aim of the present work is to assess the nutritional status among different rheumatic diseases patients and to study its association with the corresponding diseases activity.
Detailed description
Rheumatoid arthritis (RA) is an autoimmune, progressive, systemic disease of connective tissue. It is characterized by arthritis (symmetrical in most cases), extra-articular and systemic change. Spondyloarthritis (SpA) is an interconnected group of rheumatic disorders including ankylosing spondylitis (AS) and psoriatic arthritis (PsA), characterized by common clinical symptoms and a similar genetic background .Systemic Lupus Erythematous (SLE) is a chronic connective tissue disease characterized by a multi-system inflammatory disorder with immune system imbalance .Systemic sclerosis (SSc) is an immune-mediated rheumatic disease characterized by fibrosis of the skin and internal organs as well as vasculopathy . Nutritional status has been widely related to immunity; under-nutrition is associated with immunosuppression and increased susceptibility to infection whereas over-nutrition is associated with low-grade chronic inflammation increasing the risk and affecting the prognosis in metabolic, cardiovascular, and autoimmune diseases . Patients with rheumatic diseases are prone to develop malnutrition as their medications often affect appetite, nutrient absorption and digestion.Despite the high incidence of malnutrition and its consequences, there is no universally accepted definition for diagnosing nutritional deficiencies, and nutritional assessment still relies on analyses of a combination of several anthropometric, biochemical, immunological, functional and body composition data, in addition to dietary intake and the evaluation of clinical status. Four malnutrition diagnostic tools are currently used in adults: Subjective Global Assessment (SGA) ; Mini Nutritional Assessment (MNA) ; Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition malnutrition consensus characteristics; and Global Leadership Initiative on Malnutrition criteria. Certain objective nutritional assessment indices reflect the immune nutritional status of patients, such as the prognostic nutritional index (PNI) ; and the nutritional risk index (NRI) which are calculated using serum albumin level and lymphocyte count, were found to be related to the nutritional status and disease activity in SLE patients .
Interventions
None listed
Sponsors
Cairo University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Patients diagnosed with rheumatic diseases including RA, SpA, SLE and SSc.
Exclusion criteria
1. Patients who are unable to comply with the physician assessment. 2. Patients with other connective tissue diseases, neurological diseases, malignancy, heart failure or severe renal dysfunction was excluded, as these diseases affect the muscle mass causing sarcopenia. 3. Advanced liver diseases
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nutritional Status as Assessed by the Prognostic Nutritional Index (PNI) | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The Prognostic Nutritional Index (PNI) is an index score calculated using the formula: Serum Albumin (g/L) + 5 × Total Lymphocyte Count (/mm³). Unit of Measure: Calculated Index Score Interpretation: Higher scores indicate better nutritional status |
| Nutritional Risk as Assessed by the Nutritional Risk Index (NRI) | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The Nutritional Risk Index (NRI) is an index score calculated based on serum albumin levels and the percentage of weight loss. Unit of Measure: Calculated Index Score Interpretation: Higher scores indicate a lower nutritional risk |
| Nutritional Status as Assessed by the Subjective Global Assessment (SGA) | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The Subjective Global Assessment (SGA) is a clinical tool that results in a score based on a patient questionnaire and physical examination. Unit of Measure: Score on a 7-point scale Interpretation: Higher scores indicate better nutritional status. |
| Nutritional Status as Assessed by the Mini Nutritional Assessment - Short Form (MNA-SF) | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025 | The Mini Nutritional Assessment - Short Form (MNA-SF) is a screening tool consisting of a questionnaire administered to the patient. Unit of Measure: Score on a 14-point scale Interpretation: Scores are categorized as: 12-14 (normal nutritional status), 8-11 (at risk of malnutrition), or 0-7 (malnourished). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| corrolation between Body Mass Index (BMI) and disease activity | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025 | Body Mass Index (BMI) will be calculated as weight in kilograms divided by the square of height in meters (kg/m\^2). This will be reported as a continuous variable. Additionally, the percentage of participants in each standard BMI category (e.g., underweight, normal, overweight, obese) will be determined. * Unit of Measure: kg/m\^2 and Percentage of participants. |
| corrolation between Prognostic Nutritional Index (PNI) and disease activity | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | PrognostiThe Prognostic Nutritional Index (PNI) score will be calculated using the formula: Serum Albumin (g/L) + 5 × Total Lymphocyte Count (/mm³). The resulting score, where higher values indicate better nutritional status, will be reported as a continuous variable. * Unit of Measure: Calculated Index Score. |
| corrolation between Nutritional Risk Index (NRI) and disease activity | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The Nutritional Risk Index (NRI) score will be calculated based on serum albumin levels and patient weight changes. The resulting score, where higher values indicate lower nutritional risk, will be reported as a continuous variable. * Unit of Measure: Calculated Index Score |
| Corrolation between Nutritional Status Categorization by Subjective Global Assessment (SGA) and disease activity | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The Subjective Global Assessment (SGA) will be used to classify participants into distinct nutritional categories: well-nourished, mildly/moderately malnourished, or severely malnourished. * Unit of Measure: Percentage of participants in each category. |
| Duration of Rheumatic Disease | Assessed during routine clinic visits between January 1, 2023, and December 30, 2025. | The duration of a patient's rheumatic disease is recorded from the date of initial diagnosis as documented in their medical history. This variable will be used to assess the correlation between disease duration and various measures of nutritional status. Unit of Measure: Years |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORDina Ossama Abdulazim, assistant professor
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University
Outcome results
None listed