AB1177 CONNECTIONS BETWEEN EUSTAR–AI, GASTROINTESTINAL SYMPTOMS, AND NUTRITIONAL STATUS IN SCLERODERMA: A SINGLE CENTER PERSPECTIVE
Authors: I. Bratoiu, A. M. Burlui, E. Rezus
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> In systemic sclerosis (SS) there is a high chance of experiencing changes in the nutritional status due to various factors. There is a possible connection between the severity of the digestive symptoms and weight loss or malnutrition, but little evidence is available. Disease activity may also impact the degree of weight loss and malnutrition <h3>Objectives:</h3> We aimed to explore the links between digestive involvement, malnutrition, and SS activity. <h3>Methods:</h3> We included adult patients diagnosed with SS according to the ACR/EULAR 2013 classification criteria who presented in the Rheumatology Department of the Clinical Rehabilitation Hospital of Iasi. We used a translated, adapted, and validated version of the University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument 2.0 questionnaire (UCLA GIT 2.0) to evaluate digestive symptoms. The nutritional status was analyzed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. The modified Rodnan skin score (mRSS) was used for the assessment of skin involvement, and disease activity was assessed with EUSTAR-AI (European Scleroderma Trials and Research Group Activity Index). <h3>Results:</h3> The final study group included 80 patients, with a mean disease duration of 9.41± 6.51 years and a mean EUSTAR-AI of 2.2 (Table 1). UCLA-GIT was correlated with EUSTAR-AI disease activity measurement, with results approaching statistical significance (p=0.052). Furthermore, higher EUSTAR-AI scores were associated with malnutrition according to MUST (p=0.036), MNA (p&lt;0.001) and GLIM (p=0.021). Digestive symptoms were present in more than half of the patients. The inter-incisor distance was correlated with BMI values (p=0.006), but not with recent weight loss. Nevertheless, patients with lower inter-incisor distance had higher EUSTAR-AI values (p=0.048). UCLA-GIT was significantly associated with MNA (Screening: p=0.006, Assessment: p=0.002; Malnutrition Indicator Score: p=0.000). A notable correlation was obtained between mRSS and MNA (Screening: p=0.016; Assessment: p=0.020; Malnutrition Indicator Score: p=0.005). According to MNA, malnourished subjects had higher scores for the reflux (p=0.004), social function (p=0.020), and emotional well-being (p&lt;0.001) domains of the UCLA-GIT score. Based on GLIM, patients with stage 2 malnutrition (severe) had the highest UCLA-GIT scores (p=0.020) and the poorest emotional well-being (p=0.050). The patients with a high risk of malnutrition according to MUST had more severe gastrointestinal involvement (UCLA-GIT, p=0.027). <h3>Conclusion:</h3> In our study group, MNA, MUST and GLIM criteria were associated with disease activity and gastrointestinal involvement. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>