title: Nutritional status measured by BMI is impaired and correlates with left ventricular mass in patients with systemic sclerosis.
abstract: OBJECTIVE
  Systemic sclerosis (SSc) is a multisystemic chronic disease that is complicated by protein-energy malnutrition (PEM). Considering that PEM also may influence left ventricular mass (LVM), the aim of this study was to evaluate whether LVM is related to patients' nutritional status and to determine clinically relevant features of SSc.
  
  
  METHODS
  Adult patients referring to our institution were considered. Body weight, height, body mass index (BMI), involuntary weight loss, and the presence of gastrointestinal symptoms were recorded. Echocardiography was performed to assess LVM, using the Devereux regression formula. Results were then normalized by body surface area. Pattern, skin thickening, disease activity and severity, and duration were assessed to characterize SSc.
  
  
  RESULTS
  Ninety-four patents with SSc (81 women and 13 men; median duration of disease 7 y) were studied. The prevalence of PEM as assessed by BMI < 20 kg/m(2) was 19%, whereas 15% of patients reported involuntary weight loss of any degree. Patients who lost weight reported gastrointestinal symptoms more frequently (P < 0.05). PEM was not associated with disease activity. LVM (g/m(2)) correlated with patients' BMI (r = 0.32; P < 0.01), and the vascular domain of disease severity (DDS; r = 0.21; P < 0.05), but it showed a negative correlation with skin thickening (r = -0.21 P = 0.01). Patients with ulcers had a significantly greater LVM than patients without skin lesions.
  
  
  CONCLUSIONS
  Our study shows that LVM correlates with patients' BMI, skin thickening, and the vascular domain of DSS. Therefore, LVM could serve as a marker of nutritional status and fibrosis in patients with SSc.
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosato
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Gigante
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Maria Ludovica
authors.initials: ML
authors.lastname: Gasperini
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Ilenia
authors.initials: I
authors.lastname: Molinaro
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Lazzaro Giraldi
authors.affiliation: Department of Clinical Medicine and Rheumatology, Campus Bio-Medico University, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Afeltra
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Daria
authors.initials: D
authors.lastname: Amoroso
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Salsano
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Rossi Fanelli
authors.affiliation: Department of Clinical Medicine, Sapienza University, Rome, Italy. Electronic address: alessandro.laviano@uniroma1.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Laviano
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001830:Body Surface Area; D004452:Echocardiography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D015995:Prevalence; D011502:Protein-Energy Malnutrition / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000150:complications / Q000503:physiopathology*; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000503:physiopathology*; D015431:Weight Loss
keywords: Echocardiography; Gastrointestinal symptoms; Left ventricular mass; Protein–energy malnutrition; Skin thickening; Systemic sclerosis; Weight loss