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炎症性肠病患者的营养不良患病率、相关危险因素,以及营养支持的应用。

Prevalence of Malnutrition, Its Risk Factors, and the Use of Nutrition Support in Patients with Inflammatory Bowel Disease.

机构信息

Inflammatory Bowel Disease Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Inflamm Bowel Dis. 2022 Jun 2;28(Suppl 2):S59-S66. doi: 10.1093/ibd/izab345.

Abstract

BACKGROUND

Malnutrition is prevalent among patients with inflammatory bowel disease (IBD). Nutritional profiles among Asian patients with IBD have seldom been investigated. We assessed the prevalence of and risk factors for malnutrition, use of nutrition support, and sociopsychological status associated with malnutrition among patients with IBD in China.

METHODS

Patients with ulcerative colitis and Crohn's disease (CD) recruited from 43 tertiary referral hospitals were screened for malnutrition and nutrient deficiencies in this cross-sectional study. The use of nutrition support was recorded. The sociopsychological status was assessed by subjective questionnaires. Factors associated with malnutrition were analyzed, and multivariate regression was used to determine independent predictors for malnutrition.

RESULTS

We recruited 1013 patients with a median age of 35.0 years, 58.5% of them had CD, and 61.4% of all patients were male. Overall, 49.5% (n = 501) of patients were diagnosed with malnutrition, including 57.0% of patients with CD, 38.8% of patients with ulcerative colitis, and 44.1% of patients with quiescent or mildly active disease. Nutrient deficiencies were prevalent despite the absence of malnutrition. Malnutrition was associated with adverse sociopsychological status, including decreased social support, higher perceived stress, and impaired quality of life. Moderate to severe disease activity and extensive disease were 2 independent risk factors for malnutrition. In total, 41.6% of patients received nutrition support, and patients with risk factors were more likely to receive nutrition support.

CONCLUSIONS

Malnutrition was highly prevalent and associated with adverse consequences in Chinese patients with IBD. Malnutrition screening and early initiation of nutrition support are essential components in IBD care.

摘要

背景

炎症性肠病(IBD)患者普遍存在营养不良。亚洲 IBD 患者的营养状况很少被研究。我们评估了中国 IBD 患者营养不良的患病率和危险因素、营养支持的使用以及与营养不良相关的社会心理状况。

方法

在这项横断面研究中,从 43 家三级转诊医院招募了溃疡性结肠炎和克罗恩病(CD)患者,对其进行营养不良和营养缺乏筛查。记录营养支持的使用情况。通过主观问卷评估社会心理状况。分析与营养不良相关的因素,并使用多元回归确定营养不良的独立预测因素。

结果

我们招募了 1013 名中位年龄为 35.0 岁的患者,其中 58.5%为 CD,所有患者中有 61.4%为男性。总体而言,49.5%(n=501)的患者被诊断为营养不良,其中 57.0%的 CD 患者、38.8%的溃疡性结肠炎患者和 44.1%的静止或轻度活动疾病患者。尽管没有营养不良,但营养缺乏仍然很普遍。营养不良与不良的社会心理状况相关,包括社会支持减少、感知压力增加和生活质量受损。中度至重度疾病活动和广泛的疾病是营养不良的 2 个独立危险因素。总共有 41.6%的患者接受了营养支持,有危险因素的患者更有可能接受营养支持。

结论

营养不良在中国 IBD 患者中非常普遍,并与不良后果相关。营养不良筛查和早期开始营养支持是 IBD 治疗的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8155/10686604/82b3a964c723/izab345_fig1.jpg

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