Wang Yuexin, Yao Danhua, He Yining, He Qi, Li Yousheng
Department of General Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.
Biostatistics Office of Clinical Research Unit, Shanghai Jiao Tong University School of Medicine Affiliated Ninth People's Hospital, Shanghai, China.
Front Nutr. 2023 Feb 7;10:1114758. doi: 10.3389/fnut.2023.1114758. eCollection 2023.
Anti-TNF therapy has been found to exert an influence on long-term nutritional status and even reverse malnutrition in patients with Crohn's disease.
to observe the effect of anti-TNF therapy on nutritional status in patients with Crohn's disease, investigate the correlation between the timing of anti-TNF therapy and the human body composition and examine independent body composition factors for predicting malnutrition in these patients.
This was a retrospective study of 115 patients with Crohn's disease. Body composition parameters were assessed by bioelectrical impedance analysis. The nutritional status of the patients was determined by NRS2002 and MNA.
The BMI, BFMI, FFMI, BCMI, SMI, BMC, intracellular water, protein and BMR were significantly lower in patients without any biologic agents ( < 0.05). Negative correlations were found between BMC, intracellular water, extracellular water, protein and BMR and the interval between the first symptom and first dose by Spearman's correlation analysis ( < 0, < 0.05). Low BMI (OR 0.602, 95% CI 0.434-0.836, = 0.002), low FFMI (OR 0.678, 95% CI 0.507-0.906, = 0.009), and low BCMI (OR 0.564, 95% CI 0.367-0.868, = 0.009) were independent risk factors for malnutrition in Crohn's disease patients. Anti-TNF therapy tended to reduce the malnutrition probability as assessed by Cox regression analysis (OR: 0.217, 95% CI 0.057-0.821, = 0.024).
Body composition analysis is predictive of malnutrition in patients with Crohn's disease. Early application of anti-TNF therapy significantly affected skeletal muscle mass, fat mass and bone mineral content, supporting their long-term nutritional status and reducing their probability of malnutrition.
已发现抗TNF治疗对克罗恩病患者的长期营养状况有影响，甚至可逆转营养不良。
观察抗TNF治疗对克罗恩病患者营养状况的影响，研究抗TNF治疗时机与人体成分之间的相关性，并检查预测这些患者营养不良的独立人体成分因素。
这是一项对115例克罗恩病患者的回顾性研究。通过生物电阻抗分析评估人体成分参数。患者的营养状况通过NRS2002和MNA确定。
未使用任何生物制剂的患者的BMI、BFMI、FFMI、BCMI、SMI、BMC、细胞内液、蛋白质和BMR显著较低（<0.05）。通过Spearman相关分析发现，BMC、细胞内液、细胞外液、蛋白质和BMR与首次症状出现至首次给药的间隔时间呈负相关（<0，<0.05）。低BMI（OR 0.602，95%CI 0.434-0.836，=0.002）、低FFMI（OR 0.678，95%CI 0.507-0.906，=0.009）和低BCMI（OR 0.564，95%CI 0.367-0.868，=0.009）是克罗恩病患者营养不良的独立危险因素。通过Cox回归分析评估，抗TNF治疗倾向于降低营养不良概率（OR：0.217，95%CI 0.057-0.821，=0.024）。
人体成分分析可预测克罗恩病患者的营养不良。早期应用抗TNF治疗显著影响骨骼肌质量、脂肪量和骨矿物质含量，有助于维持其长期营养状况并降低营养不良概率。
