Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China.
Hunan International Scientific and Technological Cooperation Base of Artificial Intelligence Computer Aided Diagnosis and Treatment for Digestive Disease, Changsha 410008, China.
Nutrients. 2022 May 28;14(11):2260. doi: 10.3390/nu14112260.
Background and Aims: Crohn’s disease (CD) is usually accompanied by malnutrition. CD-related malnutrition can increase morbidity, disability, mortality, and hospitalization costs. The purpose of this study was to find a reliable indicator for evaluating CD patients’ nutritional status. Methods: All data were retrospectively collected from Xiangya Hospital, Central South University between May 2021 and February 2022. All patients were evaluated for nutritional status using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body composition, resistance, and reactance were recorded by a body analyser, and the phase angle (PhA) was calculated simultaneously. The Mann−Whitney U test, chi-square test, Fisher’s exact test, and univariate and multivariate logistic regression analyses were used. A receiver operating characteristic (ROC) curve was built to evaluate the predictive value of differential variables for diagnosing malnutrition based on the GLIM criteria. Results: A total of 169 CD patients were enrolled, of which 74 (58.3%) males and 32 (76.2%) females were diagnosed with malnutrition; 34 (45.9%) males and 22 (68.8%) females were severely malnourished. Univariate analysis identified that as nutritional status deteriorated, body mass index, PhA, and levels of haemoglobin and albumin decreased, while platelet count, erythrocyte sedimentation rate, and levels of C-reactive protein and fibrinogen increased (p < 0.05). Logistic regression analysis revealed that the PhA was significantly independently associated with malnutrition (p < 0.05). The ROC curve analysis indicated that the optimal PhA cut-off levels of 6.11° and 5.55° could be used to predict malnutrition according to the GLIM criteria in males and females, respectively, with a PhA < 5.53° and < 5.12° indicating severe malnutrition in males and females, respectively. Conclusion: The PhA is a sensitive, noninvasive, portable, inexpensive tool that can be used to monitor and manage the nutritional status of CD patients.
克罗恩病（CD）通常伴有营养不良。CD 相关的营养不良会增加发病率、残疾率、死亡率和住院费用。本研究的目的是寻找一种可靠的指标来评估 CD 患者的营养状况。方法：所有数据均回顾性地从 2021 年 5 月至 2022 年 2 月中南大学湘雅医院收集。所有患者均根据全球营养不良倡议（GLIM）标准进行营养状况评估。通过人体分析仪记录身体成分、阻力和电抗，同时计算相位角（PhA）。采用 Mann-Whitney U 检验、卡方检验、Fisher 确切检验以及单因素和多因素逻辑回归分析。基于 GLIM 标准，构建受试者工作特征（ROC）曲线评估鉴别变量对诊断营养不良的预测价值。结果：共纳入 169 例 CD 患者，其中 74 例（58.3%）为男性，32 例（76.2%）为女性，营养不良者 32 例（45.9%）为男性，22 例（68.8%）为女性；严重营养不良者 34 例（45.9%）为男性，22 例（68.8%）为女性。单因素分析发现，随着营养状况恶化，体重指数、PhA 以及血红蛋白和白蛋白水平降低，而血小板计数、红细胞沉降率以及 C 反应蛋白和纤维蛋白原水平升高（p<0.05）。逻辑回归分析显示，PhA 与营养不良显著相关（p<0.05）。ROC 曲线分析表明，在男性和女性中，PhA 分别为 6.11°和 5.55°时，可用于预测 GLIM 标准下的营养不良，男性和女性的 PhA<5.53°和<5.12°分别提示严重营养不良。结论：PhA 是一种敏感、无创、便携、廉价的工具，可用于监测和管理 CD 患者的营养状况。
