Ghoshal Uday C, Shukla Anshuma
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India.
Trop Gastroenterol. 2008 Apr-Jun;29(2):95-7.
Patients with inflammatory bowel disease (IBD) are often under nourished. Though there are several studies evaluating nutrition in patients with IBD from the developed world, the data from developing countries are scanty, where under nutrition is predominant.
62 patients with IBD (55 ulcerative colitis [UC] and 7 Crohn's disease [CD] patients) and 42 healthy subjects (HS) were evaluated for nutrition using dietary survey, anthropometric and biochemical parameters.
Of the patients with IBD, 23 (37%) had active disease and 39 (63%) were in remission. Daily intake of calories (1725 Kcal/d [500-2458] vs. 2239 Kcal/d [1835-3000], p<0.0001), protein (40 g/d [19-96] vs. 50 g/d [29-73], p=0.001) and iron (9 mg/d [1-16] vs. 12 mg/d [9-16], p<0.0001) and anthropometric parameters of nutrition such as body mass index (BMI) (19.8 [13.7-27.5] vs. 23 [17.9-27.2], <0.0001), biceps (0.3 mm [0.1-1.9] vs. 0.5 mm [0.2-1.0], p<0.0001) and triceps (0.7 mm [0.2-2.9] vs. 1.2 mm [0.5-2.3], p<0.0001) skin fold thickness (BSF, TSF) and mid-arm muscle circumference (MAMC, 25.9 mm [15-35] vs. 26.8 mm [23-32] <0.04) were lower among the IBD patients than among the HS. Though patients with CD had a lower level of haemoglobin (median 9.2 g vs. 10.8 g, respectively; p<0.05) and serum total protein (median 6 g, range 3-7 vs. 7 g, range 3-9, respectively; p<0.05), serum albumin, BMI, BSF and TSF thicknesses, MAMC and daily intake of protein, calories, calcium and iron were comparable between UC and CD patients. Though daily dietary intake was comparable between patients with active disease and those in remission yet patients with active disease had lower BMI, MAMC and serum protein level.
Under nutrition is common in patients with IBD, particularly in those with acute exacerbation.
炎症性肠病（IBD）患者常存在营养不良。尽管有多项研究评估了来自发达国家的IBD患者的营养状况，但来自发展中国家的数据却很少，而在这些国家营养不良情况更为普遍。
采用饮食调查、人体测量和生化指标，对62例IBD患者（55例溃疡性结肠炎[UC]患者和7例克罗恩病[CD]患者）和42例健康受试者（HS）进行营养评估。
IBD患者中，23例（37%）处于疾病活动期，39例（63%）处于缓解期。IBD患者的每日热量摄入（1725千卡/天[500 - 2458] vs. 2239千卡/天[1835 - 3000]，p<0.0001）、蛋白质摄入（40克/天[19 - 96] vs. 50克/天[29 - 73]，p = 0.001）、铁摄入（9毫克/天[1 - 16] vs. 12毫克/天[9 - 16]，p<0.0001）以及营养的人体测量指标，如体重指数（BMI）（19.8[13.7 - 27.5] vs. 23[17.9 - 27.2]，p<0.0001）、肱二头肌皮褶厚度（BSF，0.3毫米[0.1 - 1.9] vs. 0.5毫米[0.2 - 1.0]，p<0.0001）和肱三头肌皮褶厚度（TSF，0.7毫米[0.2 - 2.9] vs. 1.2毫米[0.5 - 2.3]，p<0.0001）以及上臂中部肌肉周长（MAMC，25.9毫米[15 - 35] vs. 26.8毫米[23 - 32]，p<0.04）均低于HS。尽管CD患者的血红蛋白水平较低（中位数分别为9.2克 vs. 10.8克；p<0.05）和血清总蛋白水平较低（中位数分别为6克，范围3 - 7 vs. 7克，范围3 - 9；p<0.05），但UC和CD患者之间的血清白蛋白、BMI、BSF和TSF厚度、MAMC以及蛋白质、热量、钙和铁的每日摄入量相当。尽管疾病活动期患者和缓解期患者的每日饮食摄入量相当，但疾病活动期患者的BMI、MAMC和血清蛋白水平较低。
营养不良在IBD患者中很常见，尤其是在急性加重期的患者中。
