No Differences in Malnutrition Status and Prognostic Nutrition Index Between Female Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Case-Control Study.

Objectives: Malnutrition is increasingly recognised as a comorbidity in rheumatic diseases, but its clinical associations in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) remain poorly described. The aim of this case-control study was to investigate malnutrition utilising the Global Leadership Initiative on Malnutrition (GLIM) criteria and the prognostic nutrition index (PNI) in patients with SLE and RA and explore potential associations with disease activity. Methods: In this case-control study, women with SLE (n=36) were compared to women with RA (n=36). Nutritional status was assessed using the GLIM criteria and the PNI was calculated. For the cases group (SLE), disease activity was measured using SLEDAI-2K. Associations between malnutrition and clinical variables were explored with multiple simple logistic regressions and a receiver operating characteristic (ROC) curve was produced to identify a cutoff value of the PNI that would better discriminate well-nourished from malnourished patients according to the GLIM. Results: Malnutrition was identified in both patients with SLE and RA, and only 8.3% of each group was classified as well-nourished. No differences were observed between SLE and RA concerning the nutritional status or PNI values. PNI was not associated with the SLEDAI-2K and ROC analysis showed limited discriminatory ability of PNI to identify GLIM-defined malnutrition (cut-off 8.44, sensitivity 0.73, specificity 0.50). Conclusions: Malnutrition constitutes an important issue in both SLE and RA. Routine nutritional assessment should be incorporated into clinical practice and management of the aforementioned conditions in order to ensure prompt identification and intervention.