NUTRITIVNI STATUS BOLESNIKA SA SUSTAVNOM SKLEROZOM

Doroteja Perić, Mislav Radić, Dijana Perković, Danijela Marasović Krstulović, Katarina Borić, Porin Perić, Dušanka Martinović Kaliterna

Systemic sclerosis (SSc) is a rare connective tissue disease, clinically characterized by disorders in the vascular, immunological, and fibrotic pathways. Nutritional status is used as a marker for disease activity and severity, predicting mortality in patients with systemic sclerosis. The aim of this study was to determine the nutritional status (degree of malnutrition) of SSc patients and to determine the possible association of nutritional status with the state of the oral cavity, the self-assessed evaluation of health, functional disability, and degree of disease progression, as well as with the severity and activity of the underlying disease. In this study we determined the nutritional status (degree of malnutrition) in 17 patients with SSc using the Malnutrition Universal Screening Tool (MUST). From the obtained data on nutritional status, we searched for a correlation of the patients’ nutritional status with the state of their oral cavities measured by the OHIP 49 and with self-assessed evaluation of health measured by the SF-36 questionnaire, as well as with the functional disability and degree of disease progression measured by the SHAQ questionnaire. Out of a total of 17 patients, a high risk of developing malnutrition was estimated in 11 patients, while a medium risk of developing malnutrition was found in 6 patients. The only statistically significant differences (P <0.05) were obtained by the SHAQ questionnaire. Th e patients with a high risk of developing malnutrition had significantly higher values obtained by the SHAQ questionnaire. In the MUST group with a high risk of developing malnutrition, positive SCL70 values, negative ACA values, higher disease activity, and a higher incidence of general, skin, and joint symptoms were observed to be significantly more common. This pilot study suggests that there is a correlation of nutritional status (degree of malnutrition) with disease severity and activity of the underlying disease. Given the small number of patients involved in this study, additiona  studies are needed in a larger number of patients to fully confirm the conclusions of this study.

Sustavna skleroza (SSc) rijetka je bolest vezivnog tkiva, klinički obilježena poremećajima u vaskularnim, imunosnim i fibroznim putovima. Nutritivni status danas se rabi kao biljeg za aktivnost i težinu bolesti koji ujedno predviđa i smrtnost u pacijenata sa SSc-om. Cilj ovog istraživanja bio je odrediti nutritivni status (stupanj malnutricije) bolesnika sa SSc-om te odrediti moguću povezanost nutritivnog statusa sa stanjem usne šupljine, samoprocijenjenim doživljajem zdravlja, funkcionalnom onesposobljenošću i stupnjem uznapredovalosti bolesti te s težinom kliničke slike i aktivnošću osnovne bolesti. U istraživanju smo određivali nutritivni status (stupanj malnutricije) u 17 bolesnika sa SSc-om uz pomoć alata probira Malnutrition Universal Screening Tool (MUST). Iz dobivenih podataka o nutritivnom statusu tražili smo njegovu povezanost sa stanjem usne šupljine mjerenim upitnikom OHIP-49, sa samoprocijenjenim doživljajem zdravlja mjerenim upitnikom SF-36 te s funkcionalnom onesposobljenošću i stupnjem uznapredovalosti bolesti mjerenim upitnikom SHAQ. Od ukupno 17 bolesnika visoki rizik od razvoja malnutricije procijenjen je u 11 bolesnika (65%), dok je srednji rizik od razvoja malnutricije imalo 6 bolesnika (35%). Jedine znatne razlike (P < 0,05) bile su u vrijednostima upitnika SHAQ. Ispitanici s visokim rizikom od malnutricije imali su znatno više vrijednosti dobivene tim upitnikom. Kod skupine s visokim rizikom od malnutricije prema MUST-u uočene su znatno češće pozitivne vrijednosti SCL70, negativne vrijednosti ACA-e, veća aktivnost bolesti te veća učestalost općih, kožnih i zglobnih simptoma. Rezultati ovog istraživanja upućuju na povezanost nutritivnog statusa (stupnja malnutricije) s težinom kliničke slike i aktivnošću osnovne bolesti. S obzirom na malen broj bolesnika uključenih u ovo istraživanje, za potpunu potvrdu naših zaključaka potrebna su dodatna istraživanja na većem broju bolesnika.