Nutritional status in patients with rheumatoid arthritis.

Helliwell, M; Coombes, E J; Moody, B J; Batstone, G.F.; Robertson, James

doi:10.1136/ard.43.3.386

Cited by 77 publications

(42 citation statements)

References 17 publications

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“…Earlier studies have not been conclusive as TSF has been either normal (HernandezBeriain et al, 1996;Munro and Capell, 1997;GomezVaquero et al, 2001) or low (Helliwell et al, 1984). Also AMC, which was normal in both sexes in the present study, has shown similar variability in the mentioned studies.…”

Section: Discussionsupporting

confidence: 67%

“…Consequently, nutritional assessments are scarce in the clinical situation. Owing to different methods and various populations, there is a large discrepancy between studies of prevalence of malnutrition in patients with RA, ranging from 26 to 71% (Helliwell et al, 1984;Collins et al, 1987;Rayan et al, 1989;Hernandez-Beriain et al, 1996;Munro and Capell, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Tengstrand

et al. 2007

Eur J Clin Nutr

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Objective: To evaluate diagnostic instruments for assessment of nutritional status in patients with rheumatoid arthritis (RA) in relation to objective body composition data. Subjects and methods: Study subjects include 60 in-ward patients (83% women, median age 65 years). Anthropometric measures and the nutritional tools Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening tool 2002 (NRS-2002. Body composition was determined by dual-energy X-ray absorptiometry and fat-free mass index (FFMI; kg/m 2 ) and fat mass index (FMI; kg/m 2 ) were calculated. Results: Mean body mass index (BMI) for RA women and men were 24.4 and 26.9 kg/m 2 , respectively. Twelve per cent of the women and none of the few men had BMIo18.5 kg/m 2 , that is, the cutoff value for malnutrition. FFMI indicated 52% of the women and 30% of the men to be malnourished. The sensitivity and specificity for BMI to detect malnutrition according to FFMI were 27 and 100%, whereas for arm muscle circumference the sensitivity was 36% and the specificity 89% and for triceps skin fold 43 and 93%, respectively. For MNA, sensitivity was 85% and specificity 39% and for SGA 46 and 82%. Both MUST and NRS-2002 had sensitivity of 45% and specificity of 19%. Conclusion: A large proportion of in-ward RA patients had reduced FFMI. Concurrent elevation of fat mass made BMI a nonreliable tool to detect malnutrition. Of the tested clinical evaluation tools, MNA might be used as a screening instrument, but because of its low specificity it should be followed by body composition determination.

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Tengstrand

et al. 2007

Eur J Clin Nutr

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“…The only exceptions were the higher consumption of supplemental calcium by women with 2 SS=SLE, and a greater adjusted intake of supplemental iron, zinc and vitamin A by women with 2 SS=RA. The 2 SS=RA findings may reflect clinician advice regarding supplementation, given that a deficiency in the intake and=or serum levels of iron, zinc and vitamin A has previously been reported for RA patients (Kowsari et al, 1983;Helliwell et al, 1984;Honkanen et al, 1989Honkanen et al, , 1991Rauma et al, 1993;Kremer & Bigaouette, 1996).…”

Section: Discussionmentioning

confidence: 56%

“…Conversely, the lower absolute intake of energy, protein, carbohydrates and various other nutrients in women with 2 SS=RA may be related to several factors. For example, the severity of the joint inflammation in RA may limit the ability to self-feed (TougerDecker, 1988), thereby leading to a relative malnutrition in this disorder (Helliwell et al, 1984;Collins et al, 1987;van de Laar et al, 1990;Hansen et al, 1998). In addition, some patients with RA may modify their diets, or fast for periods of time, in order to reduce pain (Diethelm, 1993).…”

Section: Discussionmentioning

confidence: 99%

Nutrient intake in women with primary and secondary Sjögren's syndrome

et al. 2003

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“…Concomitant poor nutritional status has been reported, which is indicated by reduced muscle mass, low serum albumin concentration, unbalanced iron metabolism, and reduced antioxidant defense (1)(2)(3)(4). These features have been shown to be the results of increased production of tumor necrosis factor ␣ and interleukin-1 (4,5).…”

Section: Introductionmentioning

confidence: 99%

Minor impact of juvenile arthritis on nutritional status in young adult patients

Haugen¹,

Lien²,

Flatø³

et al. 2002

Arthritis & Rheumatism

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Objective. Growth abnormalities and poor nutritional status have been reported in children with juvenile idiopathic arthritis (JIA). The aim of this study was to evaluate the impact of juvenile chronic rheumatic disease on current nutritional status in adult patients in remission or with active disease. Methods. One hundred thirty-eight women and 82 men, aged >20 years, with JIA were studied after a mean disease duration of 15.5 ؎ 2.3 years. Eighty-four (61%) of the women and 49 (60%) of the men were in remission. Forty-one healthy women and 54 healthy men served as a reference group. Body composition was analyzed by dual-energy x-ray absorptiometry.Results. There was no difference in height or body mass index (BMI) between patients and healthy subjects. However, female patients with systemic disease had significantly reduced BMI compared with those with pauciarticular JIA (P < 0.001), and female patients who used or had been using corticosteroids had significantly lower weight, height, and BMI compared with the patients who had never used corticosteroids (P < 0.05). Female patients in remission had significantly more lean body mass compared with healthy controls (P < 0.05) and significantly less body fat was found in both women and men (P < 0.01 for both). Patients with active disease had the same amount of lean body mass as the healthy controls, but significantly less body fat (P < 0.05 for women and P < 0.01 for men). Conclusion. Adult patients with JIA had attained normal height, weight, and BMI, with the exception of women with systemic JIA and those who were using or had used corticosteroids. Patients with JIA in remission seemed to have a better nutritional status than healthy subjects.

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Nutritional status in patients with rheumatoid arthritis.

Cited by 77 publications

References 17 publications

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools

Nutrient intake in women with primary and secondary Sjögren's syndrome

Minor impact of juvenile arthritis on nutritional status in young adult patients

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