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克罗恩病和溃疡性结肠炎患者的身体组成

BODY COMPOSITION IN PATIENTS WITH CROHN'S DISEASE AND ULCERATIVE COLITIS.

作者信息

Back Ivi Ribeiro, Marcon Sonia Silva, Gaino Natalia Moreno, Vulcano Daniela Salate Biagioni, Dorna Mariana de Souza, Sassaki Ligia Yukie

机构信息

Universidade Estadual de Maringá, PR, Brazil.

Universidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatu, SP, Brazil.

出版信息

Arq Gastroenterol. 2017 Apr-Jun;54(2):109-114. doi: 10.1590/S0004-2803.201700000-02. Epub 2017 Mar 16.

Abstract

BACKGROUND

The nutritional status of individuals with inflammatory bowel diseases is directly related to the severity of the disease and is associated with poor prognosis and the deterioration of immune competence.

OBJECTIVE

To assess the nutritional status and the body composition of outpatients with inflammatory bowel diseases.

METHODS

A cross-sectional study was conducted with clinical and nutritional assessment of patients with Crohn's disease and ulcerative colitis. Patients were classified according to the clinical activity through Crohn's Disease Activity Index and Mayo Score. Nutritional assessment consisted of anthropometric measurements of current weight, height, mid-arm circumference, triceps skinfold thickness and thickness of adductor policis muscle, with subsequent calculation of BMI, arm muscle circumference and the mid-arm muscle area (MAMA). The phase angle (PhA) and lean and fat mass were obtained with the use of electrical bioimpedance. Descriptive statistics, chi-square test or Fisher exact test, ANOVA and t-test.

RESULTS

We evaluated 141 patients of which 54 (38.29%) had Crohn's disease and 87 (61.70%) ulcerative colitis. The mean age was 43.98 (±15.68) years in Crohn's disease and 44.28 (±16.29) years for ulcerative colitis. Most of the patients were in clinical remission of the disease (Crohn's disease: 88.89%; ulcerative colitis: 87.36%). Regarding the nutritional classification using BMI, it was found that 48.15% of Crohn's disease patients were eutrophic and 40.74% were overweight or obese; among patients with ulcerative colitis, 52.87% were classified as overweight or obese. When considering the triceps skinfold, it was observed in both groups a high percentage of overweight and obesity (Crohn's disease: 75.93%; ulcerative colitis: 72.42%). Crohn's disease patients showed the most affected nutritional status according to the nutritional variables when compared to patients with ulcerative colitis (BMI: 24.88 kg/m² x BMI: 26.56 kg/m², P=0.054; MAMA: 35.11 mm x MAMA: 40.39 mm, P=0.040; PhA: 6.46° x PhA: 6.83°, P=0.006).

CONCLUSION

Patients with inflammatory bowel diseases have a high prevalence of overweight and obesity. Crohn's disease patients had more impaired anthropometric and body composition indicators when compared to patients with ulcerative colitis.

摘要

背景

炎症性肠病患者的营养状况与疾病严重程度直接相关,且与预后不良及免疫功能下降有关。

目的

评估炎症性肠病门诊患者的营养状况和身体成分。

方法

对克罗恩病和溃疡性结肠炎患者进行临床和营养评估的横断面研究。通过克罗恩病活动指数和梅奥评分根据临床活动对患者进行分类。营养评估包括测量当前体重、身高、上臂围、肱三头肌皮褶厚度和拇收肌厚度等人体测量指标,随后计算体重指数(BMI)、上臂肌肉围和上臂中部肌肉面积(MAMA)。使用生物电阻抗法获取相位角(PhA)、瘦体重和脂肪量。采用描述性统计、卡方检验或费舍尔精确检验、方差分析和t检验。

结果

我们评估了141例患者,其中54例(38.29%)患有克罗恩病,87例(61.70%)患有溃疡性结肠炎。克罗恩病患者的平均年龄为43.98(±15.68)岁,溃疡性结肠炎患者为44.28(±16.29)岁。大多数患者处于疾病临床缓解期(克罗恩病:88.89%;溃疡性结肠炎:87.36%)。关于使用BMI进行的营养分类,发现48.15%的克罗恩病患者营养正常,40.74%超重或肥胖;在溃疡性结肠炎患者中,52.87%被分类为超重或肥胖。考虑肱三头肌皮褶时,两组中超重和肥胖的比例都很高(克罗恩病:75.93%;溃疡性结肠炎:72.42%)。与溃疡性结肠炎患者相比,根据营养变量,克罗恩病患者的营养状况受影响最大(BMI:24.88kg/m² 对比BMI:26.56kg/m²,P = 0.054;MAMA:35.11mm对比MAMA:40.39mm,P = 0.040;PhA:6.46°对比PhA:6.83°,P = 0.006)。

结论

炎症性肠病患者超重和肥胖的患病率很高。与溃疡性结肠炎患者相比,克罗恩病患者的人体测量和身体成分指标受损更严重。

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