Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silviás Children Hospital, Gothenburg, Sweden.
Premier Research LLC, Durham, NC, USA.
Scand J Gastroenterol. 2020 Feb;55(2):169-177. doi: 10.1080/00365521.2020.1716061. Epub 2020 Feb 1.
Patients with inflammatory bowel disease (IBD) often develop alterations in body composition in terms of their proportions of lean mass and fat mass, as well as reduced bone mineral density (BMD). However, there are limited data on the skeletal muscle index (SMI) and percentage fat (fat %) for young adults with childhood-onset IBD. Our aim was to investigate the body compositions of these patients, with the focus on SMI and fat %. Body composition was estimated by dual x-ray absorptiometry for 94 young adults with childhood-onset IBD aged 18-27 years, 65 of whom had ulcerative colitis. The Z-scores for SMI, fat %, and BMD were calculated using the normative data from 1,289 individuals with corresponding age. Based on the SMI and fat % Z-scores, each patient was classified as having a body composition profile that was: (i) normal; (ii) obese (fat % Z-score >1); (iii) myopenic (SMI Z-score < -1); or (iv) myopenic-obese. A higher proportion of young adults with childhood-onset IBD had a body composition profile classified as myopenic (24%) or myopenic-obese (9%), as compared to the controls (myopenic [16%, = .016]; myopenic-obese [2%, = .002]). Patients with the myopenic or myopenic-obese profile had significantly lower total body BMD Z-scores (-1.3 ± 0.7 and -1.4 ± 0.9, respectively) than patients with the normal profile (-0.2 ± 1.1; < .001 and = .004, respectively). Diagnosis of IBD in childhood represented an additional risk for low BMD, regardless of SMI Z-score. Young adults with childhood-onset IBD have a high risk for having altered body composition traits.SummaryYoung adults with childhood-onset IBD carry a high risk for altered body composition traits. The myopenic and myopenic-obese body composition profiles were more frequently observed in patients with IBD than controls, and these profiles were strongly associated with low BMD.
患有炎症性肠病（IBD）的患者常出现瘦体重和体脂肪比例以及骨密度（BMD）降低的身体成分改变。然而，关于儿童期发病的 IBD 年轻成人的骨骼肌指数（SMI）和体脂肪百分比（fat %）的数据有限。我们的目的是研究这些患者的身体成分，重点关注 SMI 和 fat %。通过双能 X 线吸收法（DXA）对 94 名年龄在 18-27 岁的儿童期发病的 IBD 年轻成人进行身体成分评估，其中 65 名患有溃疡性结肠炎。使用与年龄相对应的 1289 个人的正常值计算 SMI、fat %和 BMD 的 Z 分数。根据 SMI 和 fat %的 Z 分数，将每位患者的身体成分谱分为以下几类：（i）正常；（ii）肥胖（fat %Z 分数>1）；（iii）肌少症（SMI Z 分数<-1）；或（iv）肌少症合并肥胖。与对照组相比（肌少症[16%， = .016]；肌少症合并肥胖[2%， = .002]），更多的儿童期发病的 IBD 年轻成人的身体成分谱为肌少症（24%）或肌少症合并肥胖（9%）。肌少症或肌少症合并肥胖的患者的全身总 BMD Z 分数明显低于正常体型的患者（分别为-1.3±0.7 和-1.4±0.9， < .001 和 = .004）。无论 SMI Z 分数如何，儿童期 IBD 的诊断均为低 BMD 的额外危险因素。患有儿童期 IBD 的年轻成人存在身体成分改变的高风险。
总结
患有儿童期 IBD 的年轻成人存在身体成分改变的高风险。与对照组相比，IBD 患者中肌少症和肌少症合并肥胖的身体成分谱更为常见，且这些身体成分谱与低 BMD 密切相关。
