Skip to main content
PMC home page
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1992 Oct;51(10):1143–1148. doi: 10.1136/ard.51.10.1143

Dietary intake and nutritional status in patients with systemic sclerosis.

A C Lundberg 1, A Akesson 1, B Akesson 1
PMCID: PMC1012420  PMID: 1332633

Abstract

Oesophageal dysmotility and abnormalities of intestinal function are important manifestations in systemic sclerosis and may have a significant effect on nutrient absorption and nutritional status. In this study 30 patients with systemic sclerosis with symptoms from the gastrointestinal tract were compared with matched healthy control subjects with respect to nutrient intake (four day record), anthropometric measurements, and biochemical nutritional status. The intake of energy (8.1 and 8.4 MJ/day) and its distribution among nutrients did not differ between patients and control subjects, but the lower intake of dietary fibre among patients with systemic sclerosis suggests that they avoided food with a coarse structure, such as coarse bread. The intake of vegetables and fruit also tended to be lower among patients with systemic sclerosis. Half of the patients had a subnormal arm muscle circumference, and two patients also had a subnormal triceps skinfold thickness, indicating severe malnutrition. The concentration of ascorbic acid, alpha-tocopherol, carotene, selenium, and also the proportion of linoleic acid (18:2) in serum phosphatidylcholine was lower in patients than in control subjects.

Full text

PDF
1143

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akesson A., Akesson B., Gustafson T., Wollheim F. Gastrointestinal function in patients with progressive systemic sclerosis. Clin Rheumatol. 1985 Dec;4(4):441–448. doi: 10.1007/BF02031897. [DOI] [PubMed] [Google Scholar]
  2. Akesson A., Gustafson T., Wollheim F., Brismar J. Esophageal dysfunction and radionuclide transit in progressive systemic sclerosis. Scand J Rheumatol. 1987;16(4):291–299. doi: 10.3109/03009748709102931. [DOI] [PubMed] [Google Scholar]
  3. Akesson A., Wollheim F. A. Organ manifestations in 100 patients with progressive systemic sclerosis: a comparison between the CREST syndrome and diffuse scleroderma. Br J Rheumatol. 1989 Aug;28(4):281–286. doi: 10.1093/rheumatology/28.4.281. [DOI] [PubMed] [Google Scholar]
  4. Akesson B., Nilsson A. Intestinal absorption of phosphatidylcholine and triglyceride after ileal resection. Scand J Gastroenterol. 1988 Mar;23(2):251–256. doi: 10.3109/00365528809103976. [DOI] [PubMed] [Google Scholar]
  5. Altman R. D., Medsger T. A., Jr, Bloch D. A., Michel B. A. Predictors of survival in systemic sclerosis (scleroderma). Arthritis Rheum. 1991 Apr;34(4):403–413. doi: 10.1002/art.1780340405. [DOI] [PubMed] [Google Scholar]
  6. Borglund M., Akesson A., Akesson B. Distribution of selenium and glutathione peroxidase in plasma compared in healthy subjects and rheumatoid arthritis patients. Scand J Clin Lab Invest. 1988 Feb;48(1):27–32. doi: 10.3109/00365518809085390. [DOI] [PubMed] [Google Scholar]
  7. Cohen S. The gastrointestinal manifestations of scleroderma: pathogenesis and management. Gastroenterology. 1980 Jul;79(1):155–166. [PubMed] [Google Scholar]
  8. Ekström B., Nilsson A., Akesson B. Lipolysis of polyenoic fatty acid esters of human chylomicrons by lipoprotein lipase. Eur J Clin Invest. 1989 Jun;19(3):259–264. doi: 10.1111/j.1365-2362.1989.tb00228.x. [DOI] [PubMed] [Google Scholar]
  9. Grabowski G., Grant J. P. Nutritional support in patients with systemic scleroderma. JPEN J Parenter Enteral Nutr. 1989 Mar-Apr;13(2):147–151. doi: 10.1177/0148607189013002147. [DOI] [PubMed] [Google Scholar]
  10. Hemilä H., Roberts P., Wikström M. Activated polymorphonuclear leucocytes consume vitamin C. FEBS Lett. 1984 Dec 3;178(1):25–30. doi: 10.1016/0014-5793(84)81232-6. [DOI] [PubMed] [Google Scholar]
  11. Hendel L., Stentoft P., Aggestrup S. The progress of oesophageal involvement in progressive systemic sclerosis during D-penicillamine treatment. Scand J Rheumatol. 1989;18(3):149–155. doi: 10.3109/03009748909095412. [DOI] [PubMed] [Google Scholar]
  12. Hendel L., Worning H. Exocrine pancreatic function in patients with progressive systemic sclerosis. Scand J Gastroenterol. 1989 May;24(4):461–466. doi: 10.3109/00365528909093075. [DOI] [PubMed] [Google Scholar]
  13. Jacobsson L., Lindgärde F., Manthorpe R., Akesson B. Correlation of fatty acid composition of adipose tissue lipids and serum phosphatidylcholine and serum concentrations of micronutrients with disease duration in rheumatoid arthritis. Ann Rheum Dis. 1990 Nov;49(11):901–905. doi: 10.1136/ard.49.11.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Jepsen L. V., Eggert J. Zinc and zinc-dependent enzymes in penicillamine-treated patients with generalized scleroderma. Acta Derm Venereol. 1984;64(5):424–427. [PubMed] [Google Scholar]
  15. Johansson U., Portinsson S., Akesson A., Svantesson H., Ockerman P. A., Akesson B. Nutritional status in girls with juvenile chronic arthritis. Hum Nutr Clin Nutr. 1986 Jan;40(1):57–67. [PubMed] [Google Scholar]
  16. King C. E., Toskes P. P. Small intestine bacterial overgrowth. Gastroenterology. 1979 May;76(5 Pt 1):1035–1055. [PubMed] [Google Scholar]
  17. Mathews-Roth M. M., Stampfer M. J. Some factors affecting determination of carotenoids in serum. Clin Chem. 1984 Mar;30(3):459–461. [PubMed] [Google Scholar]
  18. Merlo A., Cohen S. Swallowing disorders. Annu Rev Med. 1988;39:17–28. doi: 10.1146/annurev.me.39.020188.000313. [DOI] [PubMed] [Google Scholar]
  19. Ng S. C., Clements P. J., Berquist W. E., Furst D. E., Paulus H. E. Home central venous hyperalimentation in fifteen patients with severe scleroderma bowel disease. Arthritis Rheum. 1989 Feb;32(2):212–216. doi: 10.1002/anr.1780320216. [DOI] [PubMed] [Google Scholar]
  20. Pazzi P., Putinati S., Bagni B., Govoni M., Trotta F. Bile acid malabsorption in progressive systemic sclerosis. Gut. 1988 Apr;29(4):552–553. doi: 10.1136/gut.29.4.552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Poirier T. J., Rankin G. B. Gastrointestinal manifestations of progressive systemic scleroderma based on a review of 364 cases. Am J Gastroenterol. 1972 Jul;58(1):30–44. [PubMed] [Google Scholar]
  22. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum. 1980 May;23(5):581–590. doi: 10.1002/art.1780230510. [DOI] [PubMed] [Google Scholar]
  23. Serup J., Hagdrup H. Vitamin D metabolites in generalized scleroderma. Evidence of a normal cutaneous and intestinal supply with vitamin D. Acta Derm Venereol. 1985;65(4):343–345. [PubMed] [Google Scholar]
  24. Stafford-Brady F. J., Kahn H. J., Ross T. M., Russell M. L. Advanced scleroderma bowel: complications and management. J Rheumatol. 1988;15(5):869–874. [PubMed] [Google Scholar]
  25. Staël von Holstein C., Ibrahimbegovic E., Walther B., Akesson B. Nutrient intake and biochemical markers of nutritional status during long-term follow-up after total and partial gastrectomy. Eur J Clin Nutr. 1992 Apr;46(4):265–272. [PubMed] [Google Scholar]
  26. Stokes M. A., Irving M. H. Mortality in patients on home parenteral nutrition. JPEN J Parenter Enteral Nutr. 1989 Mar-Apr;13(2):172–175. doi: 10.1177/0148607189013002172. [DOI] [PubMed] [Google Scholar]
  27. Symreng T. Arm anthropometry in a large reference population and in surgical patients. Clin Nutr. 1982 Dec;1(3):211–219. doi: 10.1016/0261-5614(82)90015-2. [DOI] [PubMed] [Google Scholar]
  28. Vilter R. W., Bozian R. C., Hess E. V., Zellner D. C., Petering H. G. Manifestations of copper deficiency in a patient with systemic sclerosis on intravenous hyperalimentation. N Engl J Med. 1974 Jul 25;291(4):188–191. doi: 10.1056/NEJM197407252910407. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES