AB1283-HPR GASTROINTESTINAL INVOLVEMENT AND QUALITY OF LIFE IN A COHORT OF SYSTEMIC SCLEROSIS (SSC) PATIENTS

Background:SSc is an autoimmune disease characterized by fibrosis of the skin and several internal organs involvement. The gastro intestinal tract is often affected causing a wide symptomatology that can involve the oesophagus, stomach and/or intestine.Objectives:To assess the gastro-intestinal tract with the UCLA SCTC GIT 2.0 questionnaire and the adherence to the Mediterranean diet with the Mediterranean Diet Score in a cohort of SSc patients.Methods:18 SSc patients classified with ACR/EULAR criteria (limited and diffuse subsets) were enrolled from January to April 2019, from the outpatient clinic of the University of Florence, Division of Rheumatology, Careggi Hospital. UCLA SCTC GIT 2.0 questionnaire for gastro-intestinal involvement (range 0-3), Mediterranean Diet Score (MDS range 0-14) for adherence to the Mediterranean diet, Health Assessment Questioning (range 0-3) for disability and SF-36 (range 0-100) for the quality of life were administered to patients. Data on weight and height were collected for the calculation of the Body Mass Index (BMI).Results:the18 SSc patients included had an average BMI of 23.9 ± 4.7 (M ± SD): only one patient was underweight (BMI=16.6) and 4 patients were overweight (BMI> 25).Our results show good adherence to the Mediterranean diet with a score of 9.78 ± 2.24 (M±SD) to the MDS. The quality of life assessed by SF-36 show scores were below the cut-off (<50), showing an impaired quality of general life (mental summary index = 36.32 ± 11.35 and physical summary index = 39.53 ± 8.61). Patients disability, assessed by HAQ, reports some difficulty in carrying out daily life activities due to the disease (0.52 ± 0.53- M ± SD).Gastro-intestinal involvement, measured with the UCLA GIT 2.0 questionnaire, shows moderate symptoms (0.50-1.00) in most items (reflux, abdominal distension, social function and emotional well-being), while a lower score (0.00-0.49) it was found in other items (diarrhea, constipation and faecal incontinence). Therefore, the total score of gastrointestinal involvement is moderate (0.42 ± 0.38 M ± SD).Conclusion:In SSc,Gastrointestinal involvement has a significant impact on quality of life, influencing the eating habits and sometimes leading to nutritional deficiencies. Further studies to analyse the eating habits of SSc patients are needed.References:[1]Wojteczek A, Dardzińska JA, Małgorzewicz S, Gruszecka A, Zdrojewski Z. Prevalence of malnutrition in systemic sclerosis patients assessed by different diagnostic tools.Clin Rheumatol. 2020 Jan;39(1):227-232. doi: 10.1007/s10067-019-04810-z. Epub 2019 Nov 16.[2]McMahan ZH Gastrointestinal involvement in systemic sclerosis: an update. Curr Opin Rheumatol. 2019 Nov;31(6):561-568. doi: 10.1097/BOR.0000000000000645.[3]Smith E, Pauling JD The efficacy of dietary intervention on gastrointestinal involvement in systemic sclerosis: A systematic literature review.Semin Arthritis Rheum. 2019 Aug;49(1):112-118. doi: 10.1016/j.semarthrit.2018.12.001. Epub 2018 Dec 6.Disclosure of Interests:Khadija El Aoufy: None declared, Irene Antola: None declared, Costanza Sciortino: None declared, Silvia Bellando Randone: None declared, Serena Guiducci: None declared, Daniel Furst Grant/research support from: AbbVie, Actelion, Amgen, BMS, Corbus Pharmaceuticals, the National Institutes of Health, Novartis, Pfizer, and Roche/Genentech, Consultant of: AbbVie, Actelion, Amgen, BMS, Cytori Therapeutics, Corbus Pharmaceuticals, the National Institutes of Health, Novartis, Pfizer, and Roche/Genentech, Speakers bureau: CMC Connect (McCann Health Company), Marco Matucci-Cerinic Grant/research support from: Actelion, MSD, Bristol-Myers Squibb, Speakers bureau: Acetelion, Lilly, Boehringer Ingelheim

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FRI0233 IMPACT AND ADHERENCE TO THE MEDITERRANEAN DIET IN SYSTEMIC SCLEROSIS ITALIAN PATIENTS: CORRELATION WITH GASTROINTESTINAL SYMPTOMS, MOOD DISTURBANCES AND QUALITY OF LIFE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5470 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 700.2-700

Author(s):

G. De Luca ◽

G. Natalello ◽

G. Abignano ◽

C. Campochiaro ◽

D. Temiz Karadağ ◽

...

Keyword(s):

Quality Of Life ◽

Systemic Sclerosis ◽

Mediterranean Diet ◽

Dietary Habits ◽

Anxiety And Depression ◽

Research Support ◽

Work Impairment ◽

Gi Symptoms ◽

The Mediterranean

Background:Gastrointestinal involvement(GI) is a common feature of systemic sclerosis(SSc) and can be highly disabling, representing a major cause of morbidity and reduced quality of life(QoL). The impact of dietary habits on GI symptoms, mood and QoL has not been extensively evaluated.Objectives:To evaluate the adherence to the Mediterranean Diet(MD) in an Italian multicenter cohort of SSc patients, and its impact on GI symptoms and other disease features, depression, anxiety and overall QoL.Methods:Consecutive SSc(ACR/EULAR2013) patients from 4 Italian cohorts were enrolled. Dietary habits and adherence to the MD were assessed using the 14-item MEDAS and QueMD questionnaires. Presence and severity of depressive/anxious symptoms and QoL were evaluated with the Hospital Anxiety and Depression Scale(HADS) and the SSc-HAQ(S-HAQ). GI symptoms were assessed with the Reflux Disease Questionnaire(RDQ) and the UCLA SCTC GI Tract 2.0 questionnaire(USG). Associations with patients’ lifestyle, disease characteristics, and nutritional status were explored.Results:265 patients (94.7% females; age 55.8±13.6years; disease duration 9.1±7.0years; diffuse SSc 31.8%; Scl70 + 35.8%;ulcers 23.4%;ILD 29.4%;BMI 23.7±4.4 Kg/m2; obese 11.3%,overweight 23.4%,underweight 4.9%) were enrolled.Overall MD adherence was moderate(7.5±1.9) according to MEDAS and it correlated with QueMD score(4.53±1.96)(R=.371,p<0.001). MD adherence was optimal in 39 patients(14.7%), more frequently from Central-Southern Italy(p=0.036); 189 patients(71.3%) had a good and 37(14.0%) a poor MD adherence.GI symptoms were moderate/severe according to USG in 37(14.0%) patients(USG:0.41±0.40), and heartburn was the most common GI symptom(35.2%). The prevalence of significant anxiety and depression was 24.1% and 17.0%.An inverse correlation was found between MD adherence and mood disturbances at HADS(MEDAS; R=-0.181,p=0.04), work impairment(QueMD;R=-0.247,p=0.005) and reduced QoL, both for GI (constipation at USG: R=-0.133,p=0.032) and general S-HAQ items(bowel:R=-0.181,p=0.04;severity R=-0.202,p=0.01;Raynaud:R=-0.217,p<0.001;ulcers: R=-0.207,p=0.01). MD adherence directly correlated with lung function(MEDAS;R=0.181,p=0.023 for FVC and R=0.170,p=0.03 for DLCO). Patients with MD optimal adherence had lower HADS depression(p=0.04) and S-HAQ scores(HAQ,p=0.04; Raynaud,p=0.005; ulcers,p=0.02) and lower work impairment and lost work time(p=0.03). No significant correlation emerged between MD adherence and BMI, or specific symptoms. Depression and anxiety directly correlated with the severity of reported upper GI symptoms according to both scales (RDQ-GERD:R=0.261,p=0.001; USG:R=0.263,p<0.001) and general S-HAQ items (HAQ: R=0.136,p=0.032;severity R=0.233,p<0.001;bowel: R=0.135,p=0.04;breath: R=0.133,p=0.03; ulcers: R=0.132,p=0.037). Results were confirmed after exclusion of psychiatric(11.7%) and fibromyalgic(15.5%) patients.Conclusion:Unsatisfactory MD adherence is associated with a low mood, impaired QoL, work impairment, GI and vascular symptoms in Italian SSc patients. The promotion of a healthy lifestyle could positively impact on QoL and disease status of SSc patients.References:[1]Gnagnarella P, et a. NMCD 2018. DOI: 10.1016/j.numecd.2018.06.006[2]Jaeger VK et al. PLoS One, 2016.[3]Dinu M et al. Eur J Clin Nutr 2018. doi: 10.1038/ejcn.2017.58.[4]Khanna D, et al.Arthritis Rheum. 2009. doi: 10.1002/art.24730.Acknowledgments:GILSDisclosure of Interests:Giacomo De Luca Grant/research support from: SOBI, Speakers bureau: SOBI, Novartis, Pfizer, MSD, Celgene, Gerlando Natalello: None declared, Giuseppina Abignano: None declared, Corrado Campochiaro Speakers bureau: Novartis, Pfizer, Roche, GSK, SOBI, Duygu Temiz Karadağ: None declared, Maria De Santis: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB, Silvia Laura Bosello Speakers bureau: Abbvie, Pfizer, Boehringer, Lorenzo Dagna Grant/research support from: Abbvie, BMS, Celgene, Janssen, MSD, Mundipharma Pharmaceuticals, Novartis, Pfizer, Roche, SG, SOBI, Consultant of: Abbvie, Amgen, Biogen, BMS, Celltrion, Novartis, Pfizer, Roche, SG, and SOBI

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Adherence to the Mediterranean lifestyle in patients after myocardial infarction

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.188 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

M Novakovic ◽

J Tasic ◽

B Krevel ◽

U Rajkovic ◽

M Bozic Mijovski ◽

...

Keyword(s):

Quality Of Life ◽

Myocardial Infarction ◽

Cardiac Rehabilitation ◽

Mediterranean Diet ◽

Glucose Level ◽

Eating Habits ◽

Preventive Cardiology ◽

Lipid Status ◽

The Mediterranean

Abstract Funding Acknowledgements Type of funding sources: None. OnBehalf ReKoBo study group INTRODUCTION Adherence to the Mediterranean diet is associated with decreased cardiovascular and overall mortality, and is recommended by the relevant preventive cardiology guidelines. However, besides specific dietary intake, Mediterranean lifestyle includes a series of eating habits and social behaviours. All these aspects are summed in the Medlife questionnaire. PURPOSE The aim of our study was to assess adherence to the Mediterranean lifestyle and examine associations with clinically relevant variables, in patients after myocardial infarction referred to cardiac rehabilitation. METHODS This was a single-centre cross-sectional study. Mediterranean lifestyle pattern was assessed using a validated Medlife questionnaire, which includes 28 questions (15 questions on the Mediterranean diet adherence, 6 questions on the eating habits and behaviour, and 7 questions on the social pattern of the Mediterranean lifestyle). Associations of the Medlife score with the exercise performance (assessed by the cardiopulmonary exercise testing), clinical data, demographics, lipid status, and quality of life (assessed by the HeartQol questionnaire) were assessed using Spearman’s correlation coefficient, while differences between two groups were determined with the independent-samples t-test. RESULTS There were 111 patients included in the study, mean age 55 +/- 10 years, 20% of them were women. Adherence to the Mediterranean lifestyle was not associated with age, BMI, peak VO2, total or LDL cholesterol. Also, there were no differences in terms of Medlife score between women vs. men, and between patients living in urban vs. rural areas. There were, however, significant associations between Medlife score and HDL (r = 0.239, p = 0.012), triglyceride level (r=-0.383, p < 0.001) and blood glucose level (r=-0.214, p = 0.024), and with the emotional aspects of the quality of life (r = 0.245, p = 0.017). Also, higher-educated were significantly more adherent to the Mediterranean lifestyle as compared to lower-educated patients (16.2 vs. 14.7 points, p = 0.018). CONCLUSION Poorer adherence to the Mediterranean lifestyle is associated with substandard control of lipid status and glucose level. Improvement in the Mediterranean lifestyle adherence might be a cornerstone in the cardiac rehabilitation beyond exercise training programmes.

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Quality of Life in Patients with Systemic Sclerosis Compared to the General Population and Patients with Other Chronic Conditions

The Journal of Rheumatology ◽

10.3899/jrheum.080281 ◽

2009 ◽

Vol 36 (4) ◽

pp. 768-772 ◽

Cited By ~ 42

Author(s):

MARIE HUDSON ◽

BRETT D. THOMBS ◽

RUSSELL STEELE ◽

PANTELIS PANOPALIS ◽

EVAN NEWTON ◽

...

Keyword(s):

Quality Of Life ◽

Systemic Sclerosis ◽

General Population ◽

Chronic Diseases ◽

Chronic Conditions ◽

Short Form ◽

Mental Component Summary Score ◽

Population Norms ◽

Sf 36

Objective.Systemic sclerosis (SSc) affects multiple physical, psychological, and social domains and is associated with impaired health-related quality of life (HRQOL).We compared the HRQOL of SSc patients with individuals in the general population and patients with other common chronic diseases.Methods.HRQOL of SSc patients in the Canadian Scleroderma Research Group registry was measured using version 2 of the Medical Outcomes Trust Short Form-36 (SF-36). Results were compared to US general population norms and scores reported for patients with other common chronic diseases, namely heart disease, lung disease, hypertension, diabetes, and depression.Results.SF-36 scores were available for 504 SSc patients (86% women, mean age 56 yrs, mean disease duration since onset of first non-Raynaud’s manifestation of SSc 11 yrs). The greatest impairment in SF-36 subscale scores appeared to be in the physical functioning, general health, and role physical domains. SF-36 subscale and summary scores in SSc were significantly worse compared to US general population norms for women of similar ages, except for mental health and mental component summary score, which were not significantly different, and were generally comparable to or worse than the scores of patients with other common chronic conditions.Conclusion.HRQOL of patients with SSc is significantly impaired compared to that of the general population and is comparable to or worse than that of patients with other common chronic conditions.

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Validity of the PROMIS-29 in a large Australian cohort of patients with systemic sclerosis

Journal of Scleroderma and Related Disorders ◽

10.5301/jsrd.5000243 ◽

2017 ◽

Vol 2 (3) ◽

pp. 188-195 ◽

Cited By ~ 3

Author(s):

Kathleen Morrisroe ◽

Wendy Stevens ◽

Molla Huq ◽

Joanne Sahhar ◽

Gene-Siew Ngian ◽

...

Keyword(s):

Quality Of Life ◽

Systemic Sclerosis ◽

Construct Validity ◽

Short Form ◽

Good Alternative ◽

Measurement Information ◽

Internal Reliability ◽

Sf 36 ◽

Patient Reported

Background We aimed to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) in Australian systemic sclerosis (SSc) patients. Methods SSc patients, identified through the Australian Scleroderma Cohort Study database, completed two quality-of-life instruments concurrently, the PROMIS-29 and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The construct validity of the PROMIS-29 was assessed by the correlations between the PROMIS-29 and the SF-36 and Health Assessment Questionnaire Disability Index (HAQ-DI). Cronbach's alpha was used to test the internal reliability of all instruments in Australian SSc patients and non-parametric correlation, including Spearman's correlation, was used to test the construct validity of PROMIS-29 against the SF-36 and HAQ-DI. Results A total of 477 completed questionnaires were returned, equating to a response rate of 59.6%. The mean (±SD) age of respondents at the time of the survey was 64.1 (±11.1) years. They were predominantly female (87.4%), with limited disease subtype (lcSSc) (77.8%) and long disease duration from onset of first non-Raynaud's phenomenon symptom at the time of survey (10.9 ± 11.1 years). For the correlation analysis between the PROMIS-29 and the legacy instruments, all Spearman correlation coefficients were in the logical direction and highly significant suggesting that the PROMIS-29 is a good alternative to other validated measures of disease burden. Conclusions Our study indicates that the PROMIS-29 questionnaire is a valid instrument for measuring health-related quality of life in Australian females with lcSSc of long duration.

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