Ab0303 relation between clinical anthropometric measurements and malnutrition in elderly patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is associated with an increased risk of malnutrition, especially among the elderly. However, nutritional assessments in this population are scarce in the clinical situation. Various anthropometric measurements can help to assess malnutrition.ObjectivesTo evaluate the nutritional status using anthropometric measurements in elderly patients with RA.MethodsA prospective study was conducted, including RA patients aged 65 years or older and followed in rheumatology department. Clinical findings, disease activity and nutritional profile were studied. The mini-nutritional assessment (MNA) was used to identify altered nutritional status. The anthropometric measurements studied were: Weight loss, Body mass index (BMI), Triceps skin fold thickness (TSF) which reflects fat mass, Mid-arm circumference (MAC), Arm muscle circumference (AMC) which indicates lean mass and the calf circumference (CC).ResultsSixty-three patients were included, 82% were female. Their mean age was 68.17±4.35 years. The mean duration of RA was 11 years. The average DAS28 was 3.72±1.48. The mean MNA total score was 20.19 ± 4.71 with a range of 8 to 27.5. The prevalence of malnutrition in our population was 20.6%. 55.6% of the patients were at risk of malnutrition. Only 23.8% had a normal nutritional status. The average BMI was 27.97 ± 5.44 kg/m2 [14.85 - 43.2]. The diagnosis of malnutrition according to the BMI (< 21 kg/m2) was made for 7.9% of patients, of which 4.8% were severely malnourished. The average weight loss was 2.26 ± 2.51 kg during the last month [0 – 10]. The average percentage of weight loss in the last month was 3.39 ± 4% [0-11%]. Among our patients, 26 patients (41.3%) did not report a weight loss, 19 patients (30.2%) had a weight loss of less than 5%. Eighteen patients (28.6%) had malnutrition defined as weight loss greater than or equal to 5% in one month, of whom 7 patients (11.1%) had severe malnutrition with a loss of at least 10% of their habitual weight. The mean TSF was 18.38 ±6.77 mm [5 - 30] (19.15±6.72 mm in women and 14.72±6 mm in men). 28.6% of patients had decreased values of TSF. The mean MAC was 29.48 ± 4.52 cm [18 - 40]. The mean AMC was 23.7 ± 3.64 cm [15.86-34.43] (24±3.57 cm in women and 22.19±3.75 cm in men). The AMC was decreased in 20.6% of cases. The mean CC was 33.25 ± 4.62 cm [20-43]. 31.7% of patients had a decreased CC. There were significant association between the nutritional status using the MNA and BMI, loss of weight and TSF (p=0.013, p<0.001 and p=0.05, respectively). MNA was not associated with MAC, ACM or CC (p=0.6, p=0.8 and p=0.4, respectively).ConclusionThis study showed that the prevalence of malnutrition varies depending on the used anthropometric tool. BMI, weight loss and TSF are, according to our study, reliable tools to detect the malnutrition in elderly patients with RA.Disclosure of InterestsNone declared