SİSTEMİK LUPUS ERİTEMATOZUSDA PROGNOSTİK NUTRİSYONEL İNDEKSİN HASTALIK AKTİVİTESİ İLE OLAN İLİŞKİSİNİN ARAŞTIRILMASI: TEK MERKEZ DENEYİMİ

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. GEREÇ VE 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' sı, hastalık aktivitesi düşük olanlar ile kıyaslandığında daha düşük saptanmıştır (38'e karşı 42, p

INVESTIGATION OF THE RELATIONSHIP BETWEEN PROGNOSTIC NUTRITIONAL INDEX AND DISEASE ACITIVITY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SINGLE CENTER EXPERIENCE

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. MATERIAL AND METHOD: 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

PDF

___

1.)Choi J, Kim ST, Craft J. The pathogenesis of systemic lupus erythematosus-an update. Current opinion in immunology. 2012;24:651-7.
2.)Barnett R. Systemic lupus erythematosus. Lancet. 2016;387:1711.
3.)Romero-Diaz J, Isenberg D, Ramsey-Goldman R. Measures of adult systemic lupus erythematosus: updated version of British Isles Lupus Assessment Group (BILAG 2004), European Consensus Lupus Activity Measurements (ECLAM), Systemic Lupus Activity Measure, Revised (SLAM-R), Systemic Lupus Activity Questionnaire for Population Studies (SLAQ), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Arthritis care & research. 2011;63 Suppl 1:S37-46.
4.)Onodera T, Goseki N, Kosaki G. Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai zasshi. 1984;85:1001-5.
5.)Nozoe T, Kimura Y, Ishida M, et al. Correlation of pre-operative nutritional condition with post-operative complications in surgical treatment for oesophageal carcinoma. European journal of surgical oncology. 2002;28:396-400.
6.)Mohri Y, Inoue Y, Tanaka K, et al. Prognostic nutritional index predicts postoperative outcome in colorectal cancer. World journal of surgery. 2013;37:2688-92.
7.)Pinato DJ, North BV, Sharma R. A novel, externally validated inflammation-based prognostic algorithm in hepatocellular carcinoma: the prognostic nutritional index (PNI). British journal of cancer. 2012;106:1439-45.
8.)Sun K, Chen S, Xu J, et al. The prognostic significance of the prognostic nutritional index in cancer: a systematic review and meta-analysis. Journal of cancer research and clinical oncology. 2014;140:1537-49.
9.)Schulze-Koops H. Lymphopenia and autoimmune diseases. Arthritis Res Ther. 2004;6:178-80.
10.)Yip J, Aghdassi E, Su J, et al. Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. J Rheumatol. 2010;37:1667-72.
11.)Vilá LM, Alarcón GS, McGwin G, Jr., et al. Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual. Arthritis and rheumatism. 2006;55:799-806.
12.)Yu HH, Wang LC, Lee JH, et al. Lymphopenia is associated with neuropsychiatric manifestations and disease activity in paediatric systemic lupus erythematosus patients. Rheumatology (Oxford, England). 2007;46:1492-4.
13.)Ataş N, Babaoğlu H, Demirel E, et al. Use of prognostic nutritional index in the evaluation of disease activity in patients with Behçet’s disease. European Journal of Rheumatology. 2020;7:99.
14.)Tselios K, Gladman DD, Urowitz MB. How can we define low disease activity in systemic lupus erythematosus? Seminars in arthritis and rheumatism. 2019;48:1035-40.
15.)Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis and rheumatism. 1997;40:1725.
16.)Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis and rheumatism. 2012;64:2677-86.
17.)Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. The Journal of rheumatology. 2002;29:288-91.
18.)Jain S, Gautam V, Naseem S. Acute-phase proteins: As diagnostic tool. Journal of pharmacy & bioallied sciences. 2011;3:118-27.
19.)Quinlan GJ, Martin GS, Evans TW. Albumin: biochemical properties and therapeutic potential. Hepatology (Baltimore, Md). 2005;41:1211-9.
20.)LevittDG,LevittMD.Humanserumalbuminhomeostasis:anew look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. International journal of general medicine. 2016;9:229-55.
21.)Nicholson JP, Wolmarans MR, Park GR. The role of albumin in critical illness. British journal of anaesthesia. 2000;85:599-610.
22.)Sharma K, Mogensen KM, Robinson MK. Pathophysiology of Critical Illness and Role of Nutrition. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2019;34:12-22.
23.)Gottschalk TA, Tsantikos E, Hibbs ML. Pathogenic Inflammation and Its Therapeutic Targeting in Systemic Lupus Erythematosus. Front Immunol. 2015;6:550.
24.)Ohl K, Tenbrock K. Inflammatory cytokines in systemic lupus erythematosus. Journal of Biomedicine and Biotechnology 2011. Available from: URL: https://www.hindawi.com/journals/ bmri/2011/432595/. (Accessed June 25,2021).
25.)Chen Z, Li M-T, Xu D, et al. Protein-losing enteropathy in systemic lupus erythematosus: 12 years experience from a Chinese academic center. PloS one. 2014;9:e114684.
26.)SuiM,JiaX,YuC,etal.Relationshipbetweenhypoalbuminemia, hyperlipidemia and renal severity in patients with lupus nephritis: a prospective study. Central-European journal of immunology. 2014;39:243.
27.)Yip J, Aghdassi E, Su J, et al. Serum albumin as a marker for disease activity in patients with systemic lupus erythematosus. The Journal of rheumatology. 2010;37:1667-72.
28.)Ahn S, Jung S, Song J, et al. Prognostic nutritional index is correlated with disease activity in patients with systemic lupus erythematosus. Lupus. 2018;27:1697-705.
29.)Correa-Rodríguez M, Pocovi-Gerardino G, Callejas-Rubio JL, et al. The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus. Nutrients. 2019;11:638.