Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
European Reference Network on Hepatological Diseases, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italia.
Inflamm Bowel Dis. 2024 Jul 3;30(7):1112-1120. doi: 10.1093/ibd/izad146.
Inflammatory bowel disease (IBD) patients might experience disease-related malnutrition (DRM), but prevalence and risk factors are not well defined. The primary aim of the study was to define the prevalence of DRM and micronutrient deficiency in IBD patients; the secondary aim was to assess variables related to DRM.
A multicenter, cross-sectional study was performed including consecutive adult IBD patients during a period of 2 weeks. Nutritional status was assessed with the body mass index (BMI) and the Malnutrition Universal Screening Tool. DRM was defined according to European Society for Clinical Nutrition and Metabolism guidelines.
Among the 295 enrolled patients, the prevalence of DRM was 23%, with no statistical difference between Crohn's disease and ulcerative colitis. Compared with well-nourished patients, patients with DRM showed higher rate of hospitalization in the previous month, were more often receiving systemic steroids, and had lower hemoglobin, albumin, and prealbumin levels and higher median C-reactive protein levels. At univariate logistic regression, current hospitalization, hospitalization in the previous month, low serum albumin, low BMI, high C-reactive protein, high Crohn's Disease Activity Index, and female sex were variables related to DRM. At the multivariate logistic regression, low BMI, current hospitalization and hospitalization in the previous month were significantly associated with DRM. In 23% of IBD patients, a deficiency of at least 1 micronutrient was observed, with no difference between ulcerative colitis and Crohn's disease.
DRM and microelements malnutrition are frequent conditions in the IBD population. DRM seems to be associated with disease activity and hospitalization.
炎症性肠病(IBD)患者可能会出现与疾病相关的营养不良(DRM),但其患病率和危险因素尚未明确。本研究的主要目的是确定 IBD 患者中 DRM 和微量营养素缺乏的患病率;次要目的是评估与 DRM 相关的变量。
进行了一项多中心、横断面研究,纳入了两周内的连续成年 IBD 患者。采用体重指数(BMI)和营养不良通用筛查工具评估营养状况。根据欧洲临床营养与代谢学会的指南定义 DRM。
在 295 名入组患者中,DRM 的患病率为 23%,克罗恩病和溃疡性结肠炎之间无统计学差异。与营养良好的患者相比,患有 DRM 的患者在上个月住院的比例更高,更常接受全身类固醇治疗,且血红蛋白、白蛋白和前白蛋白水平更低,C 反应蛋白水平更高。单因素逻辑回归显示,目前住院、上月住院、低血清白蛋白、低 BMI、高 C 反应蛋白、高克罗恩病活动指数和女性是与 DRM 相关的变量。多因素逻辑回归显示,低 BMI、目前住院和上月住院与 DRM 显著相关。在 23%的 IBD 患者中观察到至少 1 种微量营养素缺乏,溃疡性结肠炎和克罗恩病之间无差异。
DRM 和微量元素营养不良是 IBD 人群中的常见情况。DRM 似乎与疾病活动度和住院有关。