Prognostic nutritional index as predictor: Assessing disease activity in juvenile systemic lupus erythematosus (non-nephritic)

Background and objectives. The Prognostic Nutritional Index (PNI) is a widely utilized indicator that reflects patients’ nutritional status, which is closely associated with the development of autoimmunity, chronic inflammation, and poor prognosis for autoimmune disease. This study aims to determine the correlation between PNI and disease activity (SLEDAI scores) in Juvenile Systemic Lupus Erythematosus (JSLE) patients. Materials and methods. This analytical observational retrospective study employed Spearman’s Correlation to determine the association between JSLE disease activity and PNI. Medical record data of JSLE patients, covering their SLEDAI scores, albumin levels, lymphocyte counts, and medications were collected from 2018 to 2023. The disease activity was based on SLEDAI scores and classified into mild (0-5), moderate (6-12), and severe (>12) categories. Meanwhile, patients’ nutritional status was assessed using their PNI scores. Results. This study examined 57 patients, including 6 males and 51 females, who met the inclusion criteria. The age of these research subjects ranged from 4 to 17 years (12.7 ± 2.8). Based on the disease activity indicated by subjects’ SLEDAI scores, there were 35 mild, 18 moderate, and 4 severe cases of JSLE observed in this study. The minimum value of PNI among the subjects was 29.2, whereas the maximum value was 67.9 (44.8 ± 7.8). JSLE disease activity level was found to have a statistically significant correlation with PNI in an inverse relationship (r=-0.3; p=0.007). Conclusions. JSLE disease activity level was found to correlate negatively with PNI, emphasizing the importance of improving patients’ nutritional status in managing JSLE.