Clinical assessment
CREST
The severity of oral mucosa and skin involvement was measured by a simple scoring system (Harman scores) of 0–3 (0, quiescent; 1, mild; 2, moderate; 3, severe). For curtailing observer bias participants were assessed by a single expert physician. Body weight and height were measured by a digital scale (to the nearest 0.1 kg) and stadiometer (to the nearest 0.1 cm), respectively (Seca). Waist circumference (WC) was assessed with a no‐stretching tape measure (Seca) at the midpoint between the costal margin and the iliac crest with no pressure on the body surface. BMI was computed as weight (kg) divided by the square of height (m