Associated Factors Correlate with Disability in
Long-Standing Systemic Sclerosis Patients
Wimol Jangsombatsiri MD*, Arunee Chaiyarit PhD***, Monchand Vanichapuntu MS*, Thanuchporn Kafaksom MS*,
Supa Oncham BSc*, Nizchapha Dchapaphapeaktak MS*, Malinee Tongdee BSc*, Vassana Aumrasamee BA*,
Daruneewan Waradomwichit MD**, Prapaporn Pisitkun MD*
Affiliation :
* Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
** Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
*** Boromarajonani College of Nursing Phra-putthabat, Saraburi, Thailand
Background : The disability of systemic sclerosis (SSc) correlates with disease severity. Long-standing SSc patients with
the low disease activity suffer from incapacity as a consequence of tissue damage. The factors correlating with disability
in long-standing SSc patients have not been emphasized.
Objective : To analyze the body composition, physical function, and nutritional status in SSc patients and determine the
parameters correlated with disability.
Material and Method: Sixty of SSc patients characterized into three subgroups as: 1) diffuse SSc (dSSc; n = 46), 2) limited
SSc (lSSc, n = 6), and 3) SSc with overlap syndrome (SSc-overlap, n = 8) were enrolled. Clinical data, body composition,
physical function, and disability were evaluated.
Results : There were no difference in clinical characteristics, functional assessment, body composition, and disability among
three subgroups of SSc patients. The data analysis demonstrated the parameters strongly correlated with disability were
factors related to: 1) disease activity (ESR; R = 0.413, p = 0.001 and the dose of prednisolone; R = 0.314, p = 0.014),
2) physical function (6-meter walk test; R = 0.402, p = 0.001, and peak expiratory flow rate; R = -0.27, p = 0.37), 3) body
composition (skeletal mass; R = -0.257, p = 0.047), and 4) nutritional status (phase angle; R = -0.274, p = 0.043 and serum
albumin; R = -0.424, p = 0.001).
Conclusion : Disease activity, physical function, body composition, and nutritional status associate with disability in long-
standing SSc patients. Our findings revealed the factors that should be corrected to lessen the disability in SSc patients.
Keywords : Systemic sclerosis, Disability, Disease activity, Nutrition, Body composition, Physical function
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