Department of Clinical Nutrition, Huadong Hospital, affiliated to Fudan University, Shanghai, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, Shanghai, China.
Department of Clinical Nutrition, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong.
Nutrition. 2022 Feb;94:111514. doi: 10.1016/j.nut.2021.111514. Epub 2021 Oct 14.
Malnutrition is common in patients with inflammatory bowel disease (IBD). The Global Leadership Initiative on Malnutrition (GLIM) was proposed to assess the severity and characteristics of malnutrition. Thus, we aimed to use the latest consensus on the diagnosis of malnutrition, GLIM criteria, to evaluate malnutrition in patients with IBD.
We performed a retrospective cohort study of 73 adult patients with IBD (48 with Crohn disease and 25 with ulcerative colitis). Demographic data, clinical characteristics, and nutrition status defined by Nutritional Risk Screening (NRS) 2002 and GLIM criteria were recorded at enrollment.
According to the GLIM criteria, 43 (58.90%) patients were identified with malnutrition, and the incidence of mild to moderate malnutrition and severe malnutrition was 28.77% (21 of 73 patients) and 30.14% (22 of 73 patients), respectively. The severity of malnutrition in patients with IBD increased with the cumulative number of phenotypic criteria they met (P < 0.01). The difference in the number of etiologic indicators was only identified between patients with severe malnutrition and those without malnutrition (P < 0.05). Patients with Crohns disease had a significantly higher rate of muscle mass loss than patients with ulcerative colitis (P = 0.038) but a lower incidence of reduced food intake or assimilation (P = 0.039).
The prevalence of malnutrition according to the GLIM criteria was high in non-surgical patients with IBD, and as the degree of malnutrition worsened, more phenotypes and etiologic types appeared. The phenotypic and etiologic characteristics of GLIM were different in patients with Crohn disease than in those with ulcerative colitis.
炎症性肠病(IBD)患者常发生营养不良。全球营养不良领导倡议(GLIM)旨在评估营养不良的严重程度和特征。因此,我们旨在使用营养不良最新诊断共识,即 GLIM 标准,评估 IBD 患者的营养不良情况。
我们对 73 例成年 IBD 患者(48 例克罗恩病和 25 例溃疡性结肠炎)进行了回顾性队列研究。在入组时记录了人口统计学数据、临床特征以及营养风险筛查(NRS)2002 和 GLIM 标准定义的营养状况。
根据 GLIM 标准,43 例(58.90%)患者被诊断为营养不良,轻度至中度营养不良和重度营养不良的发生率分别为 28.77%(73 例患者中的 21 例)和 30.14%(73 例患者中的 22 例)。IBD 患者的营养不良严重程度随着满足的表型标准数量的累积而增加(P < 0.01)。仅在重度营养不良患者和无营养不良患者之间观察到病因指标数量的差异(P < 0.05)。与溃疡性结肠炎患者相比,克罗恩病患者的肌肉质量损失发生率显著更高(P = 0.038),但食物摄入或吸收减少的发生率更低(P = 0.039)。
根据 GLIM 标准,非手术 IBD 患者的营养不良发生率较高,且随着营养不良程度的加重,出现更多的表型和病因类型。GLIM 的表型和病因特征在克罗恩病患者和溃疡性结肠炎患者中有所不同。