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通过人体阻抗分析评估炎症性肠病患者的营养不良状况——一项横断面研究。

Body impedance analysis to estimate malnutrition in inflammatory bowel disease patients - A cross-sectional study.

作者信息

Reiner Johannes, Koch Kristina, Woitalla Julia, Huth Astrid, Bannert Karen, Sautter Lea, Jaster Robert, Witte Maria, Lamprecht Georg, Schäffler Holger

机构信息

Division of Gastroenterology and Endocrinology, Department of Medicine II, Rostock University Medical Center, Rostock, Germany.

Department of General, Visceral, Thoracic, Vascular and Transplant Surgery, Rostock University Medical Center, Rostock, Germany.

出版信息

J Dig Dis. 2022 Dec;23(12):687-694. doi: 10.1111/1751-2980.13155. Epub 2023 Mar 9.

Abstract

OBJECTIVE

Malnutrition is a common clinical problem in patients with inflammatory bowel diseases (IBD). However, a gold standard for the detection of malnutrition in IBD patients is lacking.

METHODS

A cross-sectional study to assess malnutrition in patients with IBD and healthy controls (HCs). Clinical characteristics (Montreal classification, disease activity, previous surgery) and mutations in the NOD2 gene in patients with Crohn's disease (CD) were obtained. We performed a nutritional assessment with screening for nutritional risk and diagnosis for malnutrition (Malnutrition Universal Screening Tool [MUST]) score, NRS-2002, European Society for Clinical Nutrition and Metabolism (ESPEN), and Global Leadership Initiative on Malnutrition (GLIM) criteria and performed body impedance analysis (BIA).

RESULTS

101 IBD patients (57 CD and 44 ulcerative colitis (UC) and 50 HC were included in a single northern German tertiary center. GLIM criteria detected malnutrition significantly more often compared to the ESPEN criteria. Active disease, a long-standing disease course, and previous surgery were associated with reduced muscle mass. IBD patients had a higher fat mass index compared to HC. Mutations in the NOD2 gene had no effect on nutritional status.

CONCLUSIONS

The GLIM criteria detect malnutrition at a higher rate compared to ESPEN. Specific disease factors might put IBD patients at a higher risk for the development of malnutrition, so these patients might benefit from a frequently performed screening, which might result in a favorable disease course.

摘要

目的

营养不良是炎症性肠病(IBD)患者常见的临床问题。然而,IBD患者营养不良的检测缺乏金标准。

方法

一项横断面研究,旨在评估IBD患者和健康对照(HC)的营养不良情况。获取了克罗恩病(CD)患者的临床特征(蒙特利尔分类、疾病活动度、既往手术史)和NOD2基因突变情况。我们采用营养不良通用筛查工具(MUST)评分、营养风险筛查2002(NRS-2002)、欧洲临床营养与代谢学会(ESPEN)以及全球营养不良领导倡议(GLIM)标准进行营养风险筛查和营养不良诊断,并进行了人体阻抗分析(BIA)。

结果

德国北部一家三级中心纳入了101例IBD患者(57例CD和44例溃疡性结肠炎(UC))以及50例HC。与ESPEN标准相比,GLIM标准检测出营养不良的频率显著更高。疾病活动期、病程较长以及既往手术与肌肉量减少有关。与HC相比,IBD患者的脂肪量指数更高。NOD2基因突变对营养状况无影响。

结论

与ESPEN相比,GLIM标准检测营养不良的比率更高。特定的疾病因素可能使IBD患者发生营养不良的风险更高,因此这些患者可能受益于频繁进行的筛查,这可能带来良好的疾病进程。

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