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营养特征评估显示,溃疡性结肠炎和克罗恩病患者营养不良的患病率相似。

Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn's Disease.

作者信息

Singh Arshdeep, Midha Vandana, Mahajan Ramit, Verma Shruti, Kakkar Chandan, Grover Jasmine, Singh Dharmatma, Kaur Ramandeep, Masih Abhishek, Bansal Namita, Wall Catherine, Sood Ajit

机构信息

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

出版信息

Dig Dis Sci. 2023 Feb;68(2):580-595. doi: 10.1007/s10620-022-07652-z. Epub 2022 Sep 5.

Abstract

BACKGROUND

Inflammatory bowel disease (IBD) is associated with an increased risk of malnutrition and sarcopenia.

AIMS

To evaluate the nutritional status of patients with IBD and determine the threshold values of different parameters of nutritional assessment to identify malnutrition.

METHODS

This was a single-centre cross-sectional analysis of adult patients with IBD [ulcerative colitis (UC) and Crohn's disease (CD)] who underwent anthropometry [body mass index (BMI), mid upper arm circumference (MUAC) and triceps-fold thickness (TSF)], body composition analysis and assessment for sarcopenia [hand-grip strength and skeletal muscle index (SMI) at L3 vertebral level)]. Age- and gender-matched healthy adults served as controls. Malnutrition was defined according to the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria.

RESULTS

A total of 406 patients [336 (82.76%) UC and 70 (17.24%) CD; mean age 40.56 ± 13.67 years; 215 (52.95%) males] with IBD and 100 healthy controls (mean age 38.69 ± 10.90 years; 56 (56%) males) were enrolled. The mean BMI, MUAC, TSF thickness, fat and lean mass, hand-grip strength, and SMI at L3 vertebral level were lower in patients with IBD compared to controls. The prevalence of malnutrition was similar in UC and CD [24.40% (n = 82) and 28.57% (n = 20), respectively (p = 0.46)]. Thresholds for fat mass in females (15.8 kg) and visceral fat index in males (0.26) were both sensitive and specific to detect malnutrition. The cutoff values of MUAC and TSF thickness to identify malnutrition were 23.25 cm and 25.25 cm, and 16.50 mm and 8.50 mm, in females and males, respectively.

CONCLUSION

Malnutrition and sarcopenia were common in patients with IBD, with the prevalence being similar in patients with both UC and CD.

摘要

背景

炎症性肠病(IBD)与营养不良和肌肉减少症风险增加相关。

目的

评估IBD患者的营养状况,并确定营养评估不同参数的阈值以识别营养不良。

方法

这是一项对成年IBD患者[溃疡性结肠炎(UC)和克罗恩病(CD)]进行的单中心横断面分析,这些患者接受了人体测量[体重指数(BMI)、上臂中部周长(MUAC)和三头肌皮褶厚度(TSF)]、身体成分分析以及肌肉减少症评估[握力和L3椎体水平的骨骼肌指数(SMI)]。年龄和性别匹配的健康成年人作为对照。根据欧洲临床营养与代谢学会(ESPEN)标准定义营养不良。

结果

共纳入406例IBD患者[336例(82.76%)UC和70例(17.24%)CD;平均年龄40.56±13.67岁;215例(52.95%)男性]和100例健康对照者(平均年龄38.69±10.90岁;56例(56%)男性)。与对照组相比,IBD患者的平均BMI、MUAC、TSF厚度、脂肪和瘦体重、握力以及L3椎体水平的SMI较低。UC和CD患者的营养不良患病率相似[分别为24.40%(n = 82)和28.57%(n = 20)(p = 0.46)]。女性脂肪量阈值(15.8 kg)和男性内脏脂肪指数阈值(0.26)对检测营养不良均具有敏感性和特异性。女性和男性识别营养不良的MUAC和TSF厚度截断值分别为23.25 cm和25.25 cm,以及16.50 mm和8.50 mm。

结论

营养不良和肌肉减少症在IBD患者中很常见,UC和CD患者的患病率相似。

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