Prognostic nutritional index is correlated with disease activity in patients with systemic lupus erythematosus

Abstract

The prognostic nutritional index (PNI), which is calculated using serum albumin level and total lymphocyte count in the peripheral blood, is regarded as an index that reflects the immunonutritional status of patients. PNI was calculated in 217 systemic lupus erythematosus (SLE) patients according to the following formula: 10 × serum albumin value (g/dL) + 0.005 × peripheral lymphocyte count (/mm). Pearson's correlation analysis was used to elucidate the correlation between continuous variables. Linear and logistic regression analyses were performed to assess the correlation between laboratory variables and SLE Disease Activity Index-2000 (SLEDAI-2 K) and to differentiate between active and inactive SLE. Ninety-three patients were classified as active SLE (SLEDAI-2 K ≥ 5) and 124 as inactive SLE. Patients with active SLE exhibited lower median PNI than those with inactive SLE (39.0 vs. 49.1, p < 0.001). Multivariable logistic regression analysis revealed PNI as an independent predictor of active SLE. Multivariable linear regression analysis revealed that PNI was significantly correlated with laboratory variables of SLEDAI-2 K, erythrocyte sedimentation rate, C-reactive protein and SLEDAI-2 K. Furthermore, in patients who switched from active to inactive SLE after treatment ( n = 55), PNI increased as disease activity improved ( p < 0.001), which suggests that PNI may be useful for estimating SLE activity.

The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus

“…As far as we are aware, only one study has investigated the association of PNI with disease activity in SLE [27]. Our findings agree with those reported by Ahn et al, where PNI was an independent predictor of active SLE in a population of Korean patients [27]. Thus, the present study considered together with previous work suggests that PNI may be a useful index for the evaluation of disease activity in lupus patients.…”

“…NRI, developed at first for assessing patients with total parenteral nutrition, was found to be a sensitive and specific predictor for identifying patients with a risk of complications after surgery [18] and later adapted and validated in the geriatric population [19]. Interestingly, Ahn et al [27] recently showed that PNI correlated with SLE disease activity, claiming that PNI may provide an effective estimation of SLE activity. However, to the best of our knowledge, there have been no studies into the significance of other immune-nutritional indexes, including the CONUT score and NRI, in terms of predicting disease activity and damage accrual in SLE patients.…”

Comparison of the Clinical Implications among Five Different Nutritional Indices in Patients with Lupus Nephritis

“…Moreover, lymphopenia has been included as a hematologic criterion according to the 1997 ACR and 2012 SLE International Collaborating Clinics SLE criteria [15,30] and has been reported to be associated with SLE disease activity and prognosis [31]. Similar findings were found in previous studies in which PNI was significantly correlated with SLE disease activity independent of other factors, supporting the results of our study [32,33].…”

Prognostic nutritional index is associated with disease severity and relapse in ANCA‐associated vasculitis

“…However, a growing amount of evidence also suggests that PNI is associated with the prognosis of patients with non‐operable malignancies and chronic diseases . Furthermore, in a previous study, we have demonstrated that PNI is associated with disease activity in patients with systemic lupus erythematosus, which is a prototypical autoimmune disease . In the present study, to the best of our knowledge, we have first evaluated the clinical significance of PNI in patients with AAV.…”