Burnham Jon M, Shults Justine, Semeao Edisio, Foster Bethany J, Zemel Babette S, Stallings Virginia A, Leonard Mary B
Department of Pediatrics, Division of Rheumatology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Am J Clin Nutr. 2005 Aug;82(2):413-20. doi: 10.1093/ajcn.82.2.413.
Crohn disease (CD) in children is associated with low body mass index (BMI), poor growth, and delayed maturation; alterations in lean and fat mass, however, are poorly characterized.
The objective was to quantify lean and fat mass in children and young adults with CD and in healthy control subjects, relative to height and pubertal maturation.
This cross-sectional study assessed whole-body lean and fat mass by using dual-energy X-ray absorptiometry in 104 subjects with CD and in 233 healthy control subjects aged 4-25 y. Linear regression was used to determine the effect of CD on body composition and to generate sex-specific SD scores (z scores) for lean and fat mass relative to height.
Subjects with CD had lower height-for-age and BMI-for-age z scores (P < 0.001 for both) than did control subjects. CD was associated with significant deficits in lean mass after adjustment for height, age, race, and Tanner stage (P = 0.003); deficits in fat mass were not observed. The mean (+/-SD) lean mass-for-height and fat mass-for-height z scores in the subjects with CD were -0.61 +/- 0.92 and -0.04 +/- 0.86, respectively. Within the control group, fat mass-for-height was positively correlated with lean mass-for height (r = 0.41, P < 0.0001); this association was absent in the subjects with CD.
Children and young adults with CD had significant deficits in lean mass but preserved fat mass, which is consistent with cachexia. Further research is needed to identify physical activity, nutritional, and antiinflammatory interventions to improve body composition in persons with CD.
儿童克罗恩病（CD）与低体重指数（BMI）、生长发育不良和成熟延迟有关；然而，瘦体重和脂肪量的改变特征尚不明确。
旨在量化患有CD的儿童和青年以及健康对照者的瘦体重和脂肪量，并与身高和青春期成熟度进行比较。
这项横断面研究采用双能X线吸收法评估了104例患有CD的受试者和233例年龄在4至25岁的健康对照者的全身瘦体重和脂肪量。采用线性回归确定CD对身体成分的影响，并生成相对于身高的瘦体重和脂肪量的性别特异性标准差分数（z分数）。
患有CD的受试者的年龄别身高和年龄别BMI的z分数均低于对照者（两者P均<0.001）。在调整身高、年龄、种族和坦纳分期后，CD与瘦体重显著不足相关（P = 0.003）；未观察到脂肪量不足。患有CD的受试者的平均（±标准差）身高别瘦体重和身高别脂肪量的z分数分别为-0.61±0.92和-0.04±0.86。在对照组中，身高别脂肪量与身高别瘦体重呈正相关（r = 0.41，P < 0.0001）；患有CD的受试者中不存在这种关联。
患有CD的儿童和青年瘦体重显著不足，但脂肪量保持正常，这与恶病质一致。需要进一步研究以确定体育活动、营养和抗炎干预措施，以改善患有CD者的身体成分。
