Nutritional Status of Patients with Hansen's Disease (Leprosy): a Case-Control Study in an Endemic Setting.

BACKGROUND

Hansen's disease (HD, leprosy) is a major public health concern in Brazil. Its microbial aetiology means that nutritional status may be a significant factor in susceptibility and immune response.

METHODS

Case-control study (n=59 cases, n=59 controls) conducted in Espírito Santo, Brazil from February to December 2025, assessing dietary intake, anthropometry, and biochemical markers of nutritional status.

RESULTS

Cases were characterized by the multibacillary form of HD (n=56, 94.9%), mostly the borderline type (81.4%, n=48). Physical inactivity was more common among cases (81.4%) than among controls (42.4%) (p<0.001), but a higher porportion of cases reporting having a structured diet (86.4% vs. 45.8%, p<0.001). There was no difference in BMI (median 26.3 kg/m2vs. 27.2 kg/m2, p=0.638), but cases exhibited lower skeletal muscle mass (median 25.7 kg vs. 31.4 kg, p=0.005) and smaller peripheral circumferences (hip 103.5 cm vs. 112.0 cm, p<0.001; chest 98.0 cm vs. 101.5 cm, p=0.021; thigh 49.0 cm vs. 53.3 cm, p<0.001), consistent with reduced skeletal muscle mass and smaller peripheral anthropometric measurements despite similar BMI, accompanied by higher leptin levels in cases (18.0 vs. 11.0 ng/mL, p<0.001). Cases had lower median levels (p<0.001) of haemoglobin (11.8 vs. 13.5 g/dL); vitamin B12 (235 vs. 420 pg/mL), vitamin D (21.4 vs. 39.7 ng/mL), zinc (60.6 vs. 88.2 mcg/dL), and selenium (62.4 vs. 89.0 mcg/L).

CONCLUSION

HD is associated with multidimensional vulnerability, reflected in marked differences in micronutrient and biomarker levels that warrant further investigation, and that indicate a need to integrate routine nutritional screening into HD patient care.