Prieto Juliana Midori Iqueda, Andrade Adriana Ribas, Magro Daniela Oliveira, Imbrizi Marcello, Nishitokukado Iêda, Ortiz-Agostinho Carmen Lucia, Dos Santos Fabiana Maria, Luzia Liania Alves, Rondo Patricia Helen de Carvalho, Leite André Zonetti de Arruda, Carrilho Flair José, Sipahi Aytan Miranda
Institute of Nutrition, Department of Nutrition, Faculty of Public Health, University of São Paulo, São Paulo, Brasil.
Department of Gastroenterology, Clinical Hospital of the University of São Paulo, University of Sao Paulo, São Paulo, Brasil.
J Can Assoc Gastroenterol. 2021 Mar 23;4(6):290-295. doi: 10.1093/jcag/gwab006. eCollection 2021 Dec.
Malnutrition among inflammatory bowel disease (IBD) subjects is well documented in literature and may emerge from factors including inadequate dietary intake, malabsorption and disease activity. The aim of this study was to complete a comprehensive nutrition assessment and explore what possibilities may help bring a better quality of life for IBD subjects.
Nutritional status based on biochemical tests, body composition and body mass index (BMI). Food intake was assessed by an alternate 3-day food record and the adequacy of intake was evaluated according to national and international references. Clinical disease activity was evaluated by the Harvey-Bradshaw index and CRP levels.
The study included 217 patients and 65 controls, where 54.4% of these patients were classified as normal weight with a mean BMI lower than controls (23.8 ± 4.9 versus 26.9 ± 4.8 kg/m, = 0.02). Patients with disease activity showed more overweight and obesity than patients with controlled disease. Vitamin B12 deficiency was present in 19% of Crohn's disease (CD), mainly in patients with ileal commitment and small bowel resections. Anemia was present in 21.7% of patients, being more common in patients with active disease (25%) and bowel resection (23%). Regarding calorie intake (EI), CD group ingested more than controls (1986.3 ± 595.9 kcal versus 1701.8 ± 478.9 kcal; = 0.003).
CD patients presented micronutrient deficiency when compared with controls, explained for other reasons than intake restrictions. Also, fat excess might have contributed to disease burden as continuously reported in the literature.
炎症性肠病(IBD)患者的营养不良在文献中有充分记载,可能源于饮食摄入不足、吸收不良和疾病活动等因素。本研究的目的是完成全面的营养评估,并探索哪些可能性可能有助于改善IBD患者的生活质量。
基于生化测试、身体成分和体重指数(BMI)评估营养状况。通过交替3天的食物记录评估食物摄入量,并根据国内和国际参考标准评估摄入量是否充足。通过哈维-布拉德肖指数和CRP水平评估临床疾病活动度。
该研究纳入了217例患者和65例对照,其中54.4%的患者体重正常,平均BMI低于对照组(23.8±4.9对26.9±4.8kg/m,P=0.02)。疾病活动期患者比疾病得到控制的患者超重和肥胖情况更多。19%的克罗恩病(CD)患者存在维生素B12缺乏,主要见于回肠受累和小肠切除的患者。21.7%的患者存在贫血,在疾病活动期患者(25%)和肠切除患者(23%)中更为常见。关于热量摄入(EI),CD组摄入的热量超过对照组(1986.3±595.9千卡对1701.8±478.9千卡;P=0.003)。
与对照组相比,CD患者存在微量营养素缺乏,其原因并非摄入受限。此外,如文献中持续报道的那样,脂肪过量可能加重了疾病负担。