Nutritional screening and extraglandular manifestations in Sjögren disease: a cross-sectional study using the controlling nutritional status score and prognostic nutritional index

BACKGROUND: Sjögren disease (SjD) is an autoimmune disorder marked by exocrine gland dysfunction and systemic extraglandular manifestations (EGM). While nutritional status plays a key role in chronic diseases, its association with EGM in SjD remains underexplored. AIMS: This study aims to evaluate the nutritional status of patients with SjD using two validated tools the Controlling Nutritional Status (CONUT) score and the Prognostic Nutritional Index (PNI) and to examine their relationship with EGM. METHODS: A cross-sectional analysis was conducted on 113 patients diagnosed with SjD, categorized into two groups: those with EGM (n = 26) and those without (n = 87). Nutritional status was assessed using serum albumin, total lymphocyte count, and total cholesterol for CONUT, and serum albumin with lymphocyte count for PNI. Clinical, serological, and laboratory data were collected, including the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI). RESULTS: The mean age of participants was 56.2 ± 10.9 years, with 94.7% being female. The EGM group exhibited a significantly higher prevalence of anti-Ro and anti-Ro-52 antibodies. Compared to the non-EGM group, the EGM group had significantly lower levels of albumin, white blood cells, neutrophils, lymphocytes, and PNI scores, and higher ESSDAI and CONUT scores. Multivariate logistic regression identified ESSDAI, CONUT and PNI scores were independently associated with the presence of EGM at diagnosis. CONCLUSION: This study underscores the importance of nutritional assessment in SjD, particularly in patients with systemic involvement. Malnutrition, as reflected by CONUT and PNI, is significantly associated with the presence of EGM. These findings highlight the need for routine nutritional screening in SjD management to support comprehensive care and improve patient outcomes.