Department of Food, Environmental and Nutritional Sciences-DEFENS, Division of Human Nutrition, Università degli Studi di Milano, Celoria 2, 20133 Milan, Italy.
Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy.
Nutrients. 2023 Apr 18;15(8):1953. doi: 10.3390/nu15081953.
Crohn's disease (CD) is a chronic inflammatory disorder that may occur in any segment of the gastrointestinal tract. Asymptomatic or untreated inflammation along with malnutrition can often coexist in patients with CD, impairing clinical outcomes, therefore the aim of this study was to assess the relationship between inflammation, malnutrition risk and nutritional status in CD patients. Consecutive adult CD outpatients aged 18-65 years were recruited. Disease activity was clinically defined by the Crohn's Disease Activity Index (CDAI), whilst anthropometry and phase angle (PhA) were measured. The Controlling Nutritional Status (CONUT) score was retrospectively calculated for screening malnutrition risk and blood samples were taken. A total of 140 CD patients with a mean age of 38.8 ± 13.9 years and an average weight of 64.9 ± 12.0 kg were included. Serum interleukin (IL)-6 concentration was increased in active-CD patients, unrelated to medical treatment, which was associated with CDAI and PhA. Based on the CONUT score, the prevalence of patients with moderate/severe malnutrition risk (score ≥ 5) was 10%, showing lower age, body mass index and fat mass, but higher IL-6 and IL-1β levels than subjects classified as not at risk (score 0-1). Finally, increased IL-6 levels and reduced PhA values were identified as independent predictors of moderate/severe malnutrition risk ( < 0.05). In conclusion, IL-6 increased in active-CD patients, which was inversely correlated with PhA. Although the CONUT score might be helpful for identifying CD patients at moderate/severe risk of malnutrition, larger studies are needed to verify these results in different settings.
克罗恩病（CD）是一种可发生于胃肠道任何部位的慢性炎症性疾病。无症状或未经治疗的炎症以及营养不良常同时存在于 CD 患者中，从而影响临床结局，因此本研究旨在评估 CD 患者炎症、营养不良风险和营养状况之间的关系。连续招募了 18-65 岁的成年 CD 门诊患者。疾病活动度通过克罗恩病活动指数（CDAI）临床定义，同时测量人体测量学和相位角（PhA）。回顾性计算控制营养状况（CONUT）评分以筛查营养不良风险，并采集血样。共纳入 140 例 CD 患者，平均年龄为 38.8 ± 13.9 岁，平均体重为 64.9 ± 12.0 kg。活动期 CD 患者血清白细胞介素（IL）-6 浓度升高，与药物治疗无关，与 CDAI 和 PhA 相关。根据 CONUT 评分，中度/重度营养不良风险（评分≥5）患者的患病率为 10%，这些患者年龄、体重指数和体脂较低，但 IL-6 和 IL-1β 水平较高，与无风险（评分 0-1）患者相比。最后，发现升高的 IL-6 水平和降低的 PhA 值是中度/重度营养不良风险的独立预测因素（<0.05）。总之，活动期 CD 患者的 IL-6 增加，与 PhA 呈负相关。虽然 CONUT 评分可能有助于识别 CD 患者存在中度/重度营养不良风险，但需要更大的研究来在不同环境中验证这些结果。
