Gong Jianfeng, Zuo Lugen, Guo Zhen, Zhang Liang, Li Yi, Gu Lili, Zhao Jie, Cao Lei, Zhu Weiming, Li Ning, Li Jieshou
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
JPEN J Parenter Enteral Nutr. 2015 Aug;39(6):713-8. doi: 10.1177/0148607114528360. Epub 2014 Mar 25.
There is controversy about nutrition status and calorie needs during phases of active versus inactive adult Crohn's disease (CD). Results have been reported in cross-sectional studies, but longitudinal data are unavailable. Our aim was to explore whether disease activity had an impact on resting energy expenditure (REE) and body composition in adult patients with CD.
Adult patients were studied on 2 occasions with active and inactive CD. REE was measured by indirect calorimetry. Body composition was estimated from bioelectrical impedance analysis. Disease activity was measured using the Crohn's Disease Activity Index (CDAI). Regression analyses of REE with CDAI score, C-reactive protein, and erythrocyte sedimentation rate were also performed.
Seventy-five patients were included. Patients with active CD had increased REE/body weight compared with patients with inactive disease (28.8 ± 5.4 vs 25.9 ± 4.3 kcal/kg, P < .001). Disease behavior and location, but not sex, had an impact on REE/body weight. Body mass index was lower in active disease than in remission (17.4 ± 3.0 vs 18.1 ± 2.6 kg/m(2), P = .010). Body composition was not affected by disease behavior or location.
Patients with remission had a better nutrition status and decreased REE compared with those with active CD. REE could also be affected by disease location and behavior.
关于成年克罗恩病（CD）活动期与非活动期的营养状况和热量需求存在争议。横断面研究已有相关报道，但缺乏纵向数据。我们的目的是探讨疾病活动度对成年CD患者静息能量消耗（REE）和身体成分的影响。
对成年患者在CD活动期和非活动期各进行一次研究。通过间接测热法测量REE。通过生物电阻抗分析估算身体成分。使用克罗恩病活动指数（CDAI）测量疾病活动度。还对REE与CDAI评分、C反应蛋白和红细胞沉降率进行了回归分析。
纳入75例患者。与非活动期疾病患者相比，活动期CD患者的REE/体重增加（28.8±5.4 vs 25.9±4.3千卡/千克，P<.001）。疾病行为和部位而非性别对REE/体重有影响。活动期疾病患者的体重指数低于缓解期（17.4±3.0 vs 18.1±2.6千克/米²，P=.010）。身体成分不受疾病行为或部位的影响。
与活动期CD患者相比，缓解期患者营养状况更好，REE降低。REE也可能受疾病部位和行为的影响。
