Department of Clinical Medicine and Surgery, Italy.
Department of Clinical Medicine and Surgery, Italy.
Clin Nutr. 2017 Apr;36(2):467-470. doi: 10.1016/j.clnu.2016.01.005. Epub 2016 Jan 22.
BACKGROUND & AIMS: Crohn's disease (CD) is a chronic intestinal disorder of unknown etiology involving any section of the gastrointestinal tract often associated with protein-energy malnutrition (PEM). Increased resting energy expenditure (REE) unmatched by adequate dietary intake is amongst the pathogenetic mechanisms proposed for PEM. Aim of this study was to evaluate REE in CD patients receiving or not immuno-suppressive therapy as compared to controls.
36 CD patients (22 M and 14 F, age range 18-55 years) clinically stable and without complications since at least 6 month were studied. REE was evaluated by indirect calorimetry and body composition by BIA. Full biochemistry was performed. Patients were divided into two groups: Group 1 (G1 = 12 patients) without and Group 2 (G2 = 24 patients) with immuno-suppressive therapy.
The two groups were similar for age, height and BMI whereas significantly differed for weight (G1 vs G2: 56.9 ± 7.44 vs 62.3 ± 8.34 kg), fat free mass (FFM: 40.4 ± 5.73 vs 48.2 ± 7.06 kg), fat mass (FM: 17.0 ± 3.55 vs 13.9 ± 5.54 kg) and phase angle (PA: 5.6 ± 1.4 vs 6.5 ± 1.0°). Serum inflammation parameters were significantly higher in G1 than in G2: hs-PCR: 7.76 ± 14.2 vs 7.16 ± 13.4 mg/dl; alfa 2-protein: 11.7 ± 3.69 vs 9.74 ± 2.08 mg/dl; fibrinogen: 424 ± 174 vs 334 ± 118 mg/dl (p < 0.05). REE was higher in G2 vs G1: 1383 ± 267 vs 1582 ± 253kcal/die (p < 0.05) both in men: 1579 ± 314 vs 1640 ± 203 and women: 1267 ± 140 vs 1380 ± 132. Nevertheless, when corrected for FFM, REE resulted higher in G1 than G2 (34.8 ± 4.89 vs 33.0 ± 4.35 kcal/kg, p < 0.05) group, also higher compared to our, age and sex matched, control population (REE/FFM: 30.9 ± 4.5 kcal/kg).
Our preliminary results show that REE when adjusted for FFM is increased in clinically stable CD patients and mildly reduced by immunosuppressive therapy possibly through a direct action on inflammation and on body composition characteristics.
克罗恩病（CD）是一种病因不明的慢性肠道疾病，涉及胃肠道的任何部位，常伴有蛋白质能量营养不良（PEM）。与适当的饮食摄入不匹配的静息能量消耗（REE）增加是 PEM 的发病机制之一。本研究旨在评估接受或不接受免疫抑制治疗的 CD 患者与对照组相比的 REE。
36 例 CD 患者（22 名男性和 14 名女性，年龄 18-55 岁）自至少 6 个月前临床稳定且无并发症。通过间接热量法评估 REE，通过 BIA 评估身体成分。进行了全面的生化检查。患者分为两组：无免疫抑制治疗的第 1 组（G1=12 例）和有免疫抑制治疗的第 2 组（G2=24 例）。
两组在年龄、身高和 BMI 方面相似，但体重（G1 与 G2：56.9±7.44 与 62.3±8.34kg）、去脂体重（FFM：40.4±5.73 与 48.2±7.06kg）、脂肪量（FM：17.0±3.55 与 13.9±5.54kg）和相位角（PA：5.6±1.4 与 6.5±1.0°）方面存在显著差异。G1 中的血清炎症参数明显高于 G2：hs-PCR：7.76±14.2 与 7.16±13.4mg/dl；α2-球蛋白：11.7±3.69 与 9.74±2.08mg/dl；纤维蛋白原：424±174 与 334±118mg/dl（p<0.05）。G2 的 REE 高于 G1：1383±267 与 1582±253kcal/die（p<0.05），男性：1579±314 与 1640±203，女性：1267±140 与 1380±132。然而，当按 FFM 校正后，G1 的 REE 高于 G2（34.8±4.89 与 33.0±4.35kcal/kg，p<0.05），也高于我们年龄和性别匹配的对照组（REE/FFM：30.9±4.5kcal/kg）。
我们的初步结果表明，临床稳定的 CD 患者的 REE 在按 FFM 校正后增加，免疫抑制治疗可能通过直接作用于炎症和身体成分特征而轻度降低。
