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Sistemik lupus eritematozusda prognostik nutrisyonel indeksin hastalık aktivitesi ile olan ilişkisinin araştırılması: Tek merkez deneyimi

Year 2021, Volume: 54 Issue: 2, 181 - 187, 31.08.2021
https://doi.org/10.20492/aeahtd.908787

Abstract

Amaç: Periferik kandaki serum albümin seviyesi ve lenfosit sayısı ile hesaplanan ve hastaların immün-beslenme durumu yansıtan prognostik nutrisyon indeks (PNI) ile Türkiye’deki SLE hastalarında hastalık aktivitesi (SLEDAI-2K) arasındaki ilişkiyi göstermeyi ve PNI’nın hastalık aktivitesinin bağımsız bir prediktörü olduğunu göstermeyi amaçladık.
Yöntem: PNI, 156 SLE hastasında aşağıdaki formüle göre hesaplandı: 10 x serum albümin değeri (g / dL) + 0.005 x periferik lenfosit sayısı (/ mm3). PNI ile laboratuvar değişkenleri arasındaki ilişkilerin analizinde Spearman korelasyon analizi kullanıldı. Laboratuvar ve klinik değişkenler ile SLE Hastalık Aktivite İndeksi-2000 (SLEDAI-2 K) arasındaki ilişkiyi göstermek için lojistik regresyon analizleri yapıldı.
Bulgular: 79’u hastalık aktivitesi yüksek (SLEDAI-2K>10)ve 77’si hastalık aktivitesi düşük toplam 156 SLE hastası çalışmaya alındı. Yüksek hastalık aktivitesine sahip SLE hastalarının medyan PNI'si, hastalık aktivitesi düşük olanlar ile kıyaslandığında daha düşük saptanmıştır (38'e karşı 42, p <0.001). Çok değişkenli lojistik regresyon analizinde PNI'nın aktif SLE'nin bağımsız bir prediktörü olduğunu göstermiştir. Spearman analizi, PNI'nın SLEDAI-2 K, komplemanlar, anti-dsDNA, eritrosit sedimantasyon hızı ve C-reaktif protein ile önemli ölçüde ilişkili olduğunu ortaya koymuştur.
Sonuç: PNI, SLE aktivitesinin değerlendirilmesinde faydalı olabilir.

Supporting Institution

yoktur

Project Number

yoktur

Thanks

dr dilek yapar

References

  • 1. Choi, J., S.T. Kim, and J. Craft, The pathogenesis of systemic lupus erythematosus-an update. Curr Opin Immunol, 2012. 24(6): p. 651-7 DOI: 10.1016/j.coi.2012.10.004.
  • 2. Barnett, R., Systemic lupus erythematosus. Lancet, 2016. 387(10029): p. 1711 DOI: 10.1016/s0140-6736(16)30266-5.
  • 3. Romero-Diaz, J., D. Isenberg, and R. Ramsey-Goldman, Measures of adult systemic lupus erythematosus: updated version of British Isles Lupus Assessment Group (BILAG 2004), European Consensus Lupus Activity Measurements (ECLAM). Arthritis Care Res (Hoboken), 2011. 63 Suppl 11(0 11): p. S37-46 DOI: 10.1002/acr.20572.
  • 4. Onodera, T., N. Goseki, and G. Kosaki, [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi, 1984. 85(9): p. 1001-5. 5. Nozoe, T., Y. Kimura, M. Ishida, H. Saeki, D. Korenaga, and K. Sugimachi, Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol, 2002. 28(4): p. 396-400 DOI: 10.1053/ejso.2002.1257.
  • 6. Mohri, Y., Y. Inoue, K. Tanaka, J. Hiro, K. Uchida, and M. Kusunoki, Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World J Surg, 2013. 37(11): p. 2688-92 DOI: 10.1007/s00268-013-2156-9.
  • 7. Pinato, D.J., B.V. North, and R. Sharma, A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI). Br J Cancer, 2012. 106(8): p. 1439-45 DOI: 10.1038/bjc.2012.92.
  • 8. Sun, K., S. Chen, J. Xu, G. Li, and Y. He, The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol, 2014. 140(9): p. 1537-49 DOI: 10.1007/s00432-014-1714-3.
  • 9. Schulze-Koops, H., Lymphopenia and autoimmune diseases. Arthritis Res Ther, 2004. 6(4): p. 178-80 DOI: 10.1186/ar1208.
  • 10. Yip, J., E. Aghdassi, J. Su, W. Lou, H. Reich, J. Bargman, et al., Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. J Rheumatol, 2010. 37(8): p. 1667-72 DOI: 10.3899/jrheum.091028.
  • 11. Vilá, L.M., G.S. Alarcón, G. McGwin, Jr., H.M. Bastian, B.J. Fessler, and J.D. Reveille, Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis Rheum, 2006. 55(5): p. 799-806 DOI: 10.1002/art.22224.
  • 12. Yu, H.H., L.C. Wang, J.H. Lee, C.C. Lee, Y.H. Yang, and B.L. Chiang, Lymphopenia is associated with neuropsychiatric manifestations and disease activity in paediatric systemic lupus erythematosus patients. Rheumatology (Oxford), 2007. 46(9): p. 1492-4 DOI: 10.1093/rheumatology/kem182.
  • 13. Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 1997. 40(9): p. 1725-1725.
  • 14. Tselios, K., D.D. Gladman, and M.B. Urowitz, How can we define low disease activity in systemic lupus erythematosus? Semin Arthritis Rheum, 2019. 48(6): p. 1035-1040 DOI: 10.1016/j.semarthrit.2018.10.013.
  • 15. Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum, 1997. 40(9): p. 1725 DOI: 10.1002/art.1780400928.
  • 16. Petri, M., A.M. Orbai, G.S. Alarcón, C. Gordon, J.T. Merrill, P.R. Fortin, et al., Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum, 2012. 64(8): p. 2677-86 DOI: 10.1002/art.34473.
  • 17. Gladman, D.D., D. Ibanez, and M.B. Urowitz, Systemic lupus erythematosus disease activity index 2000. The Journal of rheumatology, 2002. 29(2): p. 288-291.
  • 18. Jain, S., V. Gautam, and S. Naseem, Acute-phase proteins: As diagnostic tool. J Pharm Bioallied Sci, 2011. 3(1): p. 118-27 DOI: 10.4103/0975-7406.76489.
  • 19. Quinlan, G.J., G.S. Martin, and T.W. Evans, Albumin: biochemical properties and therapeutic potential. Hepatology, 2005. 41(6): p. 1211-9 DOI: 10.1002/hep.20720.
  • 20. Levitt, D.G. and M.D. Levitt, Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med, 2016. 9: p. 229-55 DOI: 10.2147/ijgm.S102819.
  • 21. Nicholson, J.P., M.R. Wolmarans, and G.R. Park, The role of albumin in critical illness. Br J Anaesth, 2000. 85(4): p. 599-610 DOI: 10.1093/bja/85.4.599.
  • 22. Sharma, K., K.M. Mogensen, and M.K. Robinson, Pathophysiology of Critical Illness and Role of Nutrition. Nutr Clin Pract, 2019. 34(1): p. 12-22 DOI: 10.1002/ncp.10232.
  • 23. Gottschalk, T.A., E. Tsantikos, and M.L. Hibbs, Pathogenic Inflammation and Its Therapeutic Targeting in Systemic Lupus Erythematosus. Front Immunol, 2015. 6: p. 550 DOI: 10.3389/fimmu.2015.00550.
  • 24. Ohl, K. and K. Tenbrock, Inflammatory cytokines in systemic lupus erythematosus. Journal of Biomedicine and Biotechnology, 2011. 2011.
  • 25. Chen, Z., M.-T. Li, D. Xu, H. Yang, J. Li, J.-L. Zhao, et al., Protein-losing enteropathy in systemic lupus erythematosus: 12 years experience from a Chinese academic center. PloS one, 2014. 9(12): p. e114684.
  • 26. Sui, M., X. Jia, C. Yu, X. Guo, X. Liu, Y. Ji, et al., Relationship between hypoalbuminemia, hyperlipidemia and renal severity in patients with lupus nephritis: a prospective study. Central-European journal of immunology, 2014. 39(2): p. 243.
  • 27. Yip, J., E. Aghdassi, J. Su, W. Lou, H. Reich, J. Bargman, et al., Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. The Journal of rheumatology, 2010. 37(8): p. 1667-1672.
  • 28. Ahn, S., S. Jung, J. Song, Y. Park, and S. Lee, Prognostic nutritional index is correlated with disease activity in patients with systemic lupus erythematosus. Lupus, 2018. 27(10): p. 1697-1705.
  • 29. Correa-Rodríguez, M., G. Pocovi-Gerardino, J.L. Callejas-Rubio, R.R. Fernández, M. Martín-Amada, M.G. Cruz-Caparros, et al., The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus. Nutrients, 2019. 11(3) DOI: 10.3390/nu11030638.

Investigation the relationship between prognostic nutritional index and disease acitivity in patients with Systemic Lupus erythematosus: A single center experience

Year 2021, Volume: 54 Issue: 2, 181 - 187, 31.08.2021
https://doi.org/10.20492/aeahtd.908787

Abstract

Aim: The prognostic nutritional index (PNI), which includes serum albumin level and total lymphocyte count in the peripheral blood, is as an index that essentially reflects the
immunonutritional status of the patients. We investigate the role of PNI with SLEDAI-2K as an independent predictor of active disease in patients with systemic lupus erythematosus (SLE) in Turkey.

Methods: PNI was calculated in 156 SLE patients according to the following formula: 10 x serum albumin value (g/dL) + 0.005 x peripheral lymphocyte count (/mm3).Spearman correlation analysis was used for analyzing correlations between PNI and laboratory variables. Logistic regression analyses were performed to assess the relationship between laboratory and clinical variables and SLE Disease Activity Index-2000 (SLEDAI-2 K).

Results: Seventy-nine patients were defined as active SLE (SLEDAI-2K>10) and 77 as inactive SLE. Patients with active SLE have lower median PNI than those with inactive SLE (38 vs. 42, p<0.001). Multivariable logistic regression analysis showed PNI as an independent predictor of active SLE. Spearman analysis revealed that PNI was significantly correlated with SLEDAI-2 K, complements, anti-dsDNA, erythrocyte sedimentation rate and C-reactive protein.
Conclusion: PNI may be useful for assessing SLE activity.

Project Number

yoktur

References

  • 1. Choi, J., S.T. Kim, and J. Craft, The pathogenesis of systemic lupus erythematosus-an update. Curr Opin Immunol, 2012. 24(6): p. 651-7 DOI: 10.1016/j.coi.2012.10.004.
  • 2. Barnett, R., Systemic lupus erythematosus. Lancet, 2016. 387(10029): p. 1711 DOI: 10.1016/s0140-6736(16)30266-5.
  • 3. Romero-Diaz, J., D. Isenberg, and R. Ramsey-Goldman, Measures of adult systemic lupus erythematosus: updated version of British Isles Lupus Assessment Group (BILAG 2004), European Consensus Lupus Activity Measurements (ECLAM). Arthritis Care Res (Hoboken), 2011. 63 Suppl 11(0 11): p. S37-46 DOI: 10.1002/acr.20572.
  • 4. Onodera, T., N. Goseki, and G. Kosaki, [Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients]. Nihon Geka Gakkai Zasshi, 1984. 85(9): p. 1001-5. 5. Nozoe, T., Y. Kimura, M. Ishida, H. Saeki, D. Korenaga, and K. Sugimachi, Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol, 2002. 28(4): p. 396-400 DOI: 10.1053/ejso.2002.1257.
  • 6. Mohri, Y., Y. Inoue, K. Tanaka, J. Hiro, K. Uchida, and M. Kusunoki, Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World J Surg, 2013. 37(11): p. 2688-92 DOI: 10.1007/s00268-013-2156-9.
  • 7. Pinato, D.J., B.V. North, and R. Sharma, A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI). Br J Cancer, 2012. 106(8): p. 1439-45 DOI: 10.1038/bjc.2012.92.
  • 8. Sun, K., S. Chen, J. Xu, G. Li, and Y. He, The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol, 2014. 140(9): p. 1537-49 DOI: 10.1007/s00432-014-1714-3.
  • 9. Schulze-Koops, H., Lymphopenia and autoimmune diseases. Arthritis Res Ther, 2004. 6(4): p. 178-80 DOI: 10.1186/ar1208.
  • 10. Yip, J., E. Aghdassi, J. Su, W. Lou, H. Reich, J. Bargman, et al., Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. J Rheumatol, 2010. 37(8): p. 1667-72 DOI: 10.3899/jrheum.091028.
  • 11. Vilá, L.M., G.S. Alarcón, G. McGwin, Jr., H.M. Bastian, B.J. Fessler, and J.D. Reveille, Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis Rheum, 2006. 55(5): p. 799-806 DOI: 10.1002/art.22224.
  • 12. Yu, H.H., L.C. Wang, J.H. Lee, C.C. Lee, Y.H. Yang, and B.L. Chiang, Lymphopenia is associated with neuropsychiatric manifestations and disease activity in paediatric systemic lupus erythematosus patients. Rheumatology (Oxford), 2007. 46(9): p. 1492-4 DOI: 10.1093/rheumatology/kem182.
  • 13. Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 1997. 40(9): p. 1725-1725.
  • 14. Tselios, K., D.D. Gladman, and M.B. Urowitz, How can we define low disease activity in systemic lupus erythematosus? Semin Arthritis Rheum, 2019. 48(6): p. 1035-1040 DOI: 10.1016/j.semarthrit.2018.10.013.
  • 15. Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum, 1997. 40(9): p. 1725 DOI: 10.1002/art.1780400928.
  • 16. Petri, M., A.M. Orbai, G.S. Alarcón, C. Gordon, J.T. Merrill, P.R. Fortin, et al., Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum, 2012. 64(8): p. 2677-86 DOI: 10.1002/art.34473.
  • 17. Gladman, D.D., D. Ibanez, and M.B. Urowitz, Systemic lupus erythematosus disease activity index 2000. The Journal of rheumatology, 2002. 29(2): p. 288-291.
  • 18. Jain, S., V. Gautam, and S. Naseem, Acute-phase proteins: As diagnostic tool. J Pharm Bioallied Sci, 2011. 3(1): p. 118-27 DOI: 10.4103/0975-7406.76489.
  • 19. Quinlan, G.J., G.S. Martin, and T.W. Evans, Albumin: biochemical properties and therapeutic potential. Hepatology, 2005. 41(6): p. 1211-9 DOI: 10.1002/hep.20720.
  • 20. Levitt, D.G. and M.D. Levitt, Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med, 2016. 9: p. 229-55 DOI: 10.2147/ijgm.S102819.
  • 21. Nicholson, J.P., M.R. Wolmarans, and G.R. Park, The role of albumin in critical illness. Br J Anaesth, 2000. 85(4): p. 599-610 DOI: 10.1093/bja/85.4.599.
  • 22. Sharma, K., K.M. Mogensen, and M.K. Robinson, Pathophysiology of Critical Illness and Role of Nutrition. Nutr Clin Pract, 2019. 34(1): p. 12-22 DOI: 10.1002/ncp.10232.
  • 23. Gottschalk, T.A., E. Tsantikos, and M.L. Hibbs, Pathogenic Inflammation and Its Therapeutic Targeting in Systemic Lupus Erythematosus. Front Immunol, 2015. 6: p. 550 DOI: 10.3389/fimmu.2015.00550.
  • 24. Ohl, K. and K. Tenbrock, Inflammatory cytokines in systemic lupus erythematosus. Journal of Biomedicine and Biotechnology, 2011. 2011.
  • 25. Chen, Z., M.-T. Li, D. Xu, H. Yang, J. Li, J.-L. Zhao, et al., Protein-losing enteropathy in systemic lupus erythematosus: 12 years experience from a Chinese academic center. PloS one, 2014. 9(12): p. e114684.
  • 26. Sui, M., X. Jia, C. Yu, X. Guo, X. Liu, Y. Ji, et al., Relationship between hypoalbuminemia, hyperlipidemia and renal severity in patients with lupus nephritis: a prospective study. Central-European journal of immunology, 2014. 39(2): p. 243.
  • 27. Yip, J., E. Aghdassi, J. Su, W. Lou, H. Reich, J. Bargman, et al., Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. The Journal of rheumatology, 2010. 37(8): p. 1667-1672.
  • 28. Ahn, S., S. Jung, J. Song, Y. Park, and S. Lee, Prognostic nutritional index is correlated with disease activity in patients with systemic lupus erythematosus. Lupus, 2018. 27(10): p. 1697-1705.
  • 29. Correa-Rodríguez, M., G. Pocovi-Gerardino, J.L. Callejas-Rubio, R.R. Fernández, M. Martín-Amada, M.G. Cruz-Caparros, et al., The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus. Nutrients, 2019. 11(3) DOI: 10.3390/nu11030638.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Original research article
Authors

Reyhan Bilici Salman 0000-0002-2523-1695

Şeminur Haznedaroğlu This is me 0000-0003-3929-6884

Project Number yoktur
Publication Date August 31, 2021
Submission Date April 5, 2021
Published in Issue Year 2021 Volume: 54 Issue: 2

Cite

AMA Bilici Salman R, Haznedaroğlu Ş. Sistemik lupus eritematozusda prognostik nutrisyonel indeksin hastalık aktivitesi ile olan ilişkisinin araştırılması: Tek merkez deneyimi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. August 2021;54(2):181-187. doi:10.20492/aeahtd.908787