Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, sala 2033, Porto Alegre, RS 90430-000, Brazil.
Dig Dis Sci. 2010 Jan;55(1):137-44. doi: 10.1007/s10620-008-0692-1. Epub 2009 Feb 20.
Crohn's disease (CD) may lead to protein and calorie malnutrition (PCM) secondary to impaired digestive and absorptive functions of the small intestine and sometimes to the influence of diet taboos. The earlier the PCM is diagnosed, the higher are the odds of reversal. The objective of this study was to compare different methods of nutritional assessment in patients with CD and correlate them with the disease characteristics.
The sample comprised 75 patients with CD from the Gastroenterology Service at the Hospital de Clínicas de Porto Alegre; 37 were male, with a mean age of 38.2 years old (SD = 13.3). All patients had been in clinical remission (CDAI <150) for over 3 months. They were not receiving enteral or parenteral nutrition. The nutritional assessment was considered: body mass index (BMI), triceps skin fold (TSF), arm circumference (MAC), arm muscle circumference (MAMC), subjective global assessment (SGA), non-dominating handgrip strength (HGS) and food intake inquiries.
When comparing the different nutritional assessment methods, 26.7% of the patients were malnourished according to the MAC, 29.3% according to the MAMC, 18.7% according to the SGA, 6.7% according to the BMI, 37.3% according to the TSF and 73.3% according to the HGS. No statistically significant associations were found for disease location, its behavior, drugs utilized, ESR, CRP, age of patients and disease time with the nutritional state verified by HGS, TSF, MAMC and SGA.
The prevalence of malnutrition is significant in patients with CD, even in clinical remission. The BMI should not be used as reference in this population. The HGS detected a high prevalence of nutritional risk in patients with CD in remission. Studies are required that correlate it with more sensitive methods, for the patients' effective nutritional state assessment.
克罗恩病（CD）可能会导致蛋白质和热量营养不良（PCM），这是由于小肠的消化和吸收功能受损，有时还受到饮食禁忌的影响。PCM 越早被诊断出来，逆转的机会就越高。本研究的目的是比较 CD 患者的不同营养评估方法，并将其与疾病特征相关联。
该样本包括来自阿雷格里港临床医院胃肠病科的 75 名 CD 患者；37 名男性，平均年龄 38.2 岁（标准差=13.3）。所有患者的临床缓解期（CDAI<150）均超过 3 个月。他们没有接受肠内或肠外营养。营养评估包括：体重指数（BMI）、三头肌皮褶厚度（TSF）、上臂围（MAC）、上臂肌围（MAMC）、主观整体评估（SGA）、非优势手握力（HGS）和食物摄入询问。
当比较不同的营养评估方法时，根据 MAC，26.7%的患者存在营养不良，根据 MAMC，29.3%的患者存在营养不良，根据 SGA，18.7%的患者存在营养不良，根据 BMI，6.7%的患者存在营养不良，根据 TSF，37.3%的患者存在营养不良，根据 HGS，73.3%的患者存在营养不良。在疾病部位、行为、使用的药物、ESR、CRP、患者年龄和疾病时间与 HGS、TSF、MAMC 和 SGA 检测到的营养状况之间未发现统计学上的显著相关性。
即使在临床缓解期，CD 患者的营养不良发生率也很高。在该人群中，BMI 不应作为参考。HGS 检测到缓解期 CD 患者存在较高的营养风险。需要进行研究，将其与更敏感的方法相关联，以评估患者的有效营养状态。
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