当代谢合并症与营养不良风险并存时：炎症性肠病的新时代。

When metabolic comorbidities and risk of malnutrition coexist: The new era of inflammatory bowel disease.

作者信息

García-Mateo Sandra, Martínez-Domínguez Samuel Jesús, Gargallo-Puyuelo Carla Jerusalén, Villarino María Teresa Arroyo, Laredo Viviana, Gallego Beatriz, Alfambra Erika, Sanz Borja, Gomollón Fernando

机构信息

Department of Gastroenterology, Lozano Blesa University Clinical Hospital, 50009 Zaragoza, Spain; Aragón Health Research Institute (IIS Aragón), 50009 Zaragoza, Spain; School of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.

出版信息

Am J Med Sci. 2025 Jan;369(1):53-61. doi: 10.1016/j.amjms.2024.07.036. Epub 2024 Aug 2.

DOI:10.1016/j.amjms.2024.07.036

PMID:39098709

Abstract

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) and risk of malnutrition can coexist in patients with inflammatory bowel disease (IBD). We performed a malnutrition risk assessment as part of the standard follow-up of IBD patients and studied the potential risk factors for being at risk of malnutrition based on the presence or absence of MASLD.

METHODS

The Malnutrition Universal Screening Tool (MUST) was used to screen malnutrition risk (MUST ≥1) and controlled attenuation parameter (CAP ≥248 dB/min) to assess MASLD. Adherence to a Mediterranean diet, physical activity, and quality of life were also assessed.

RESULTS

Of 686 evaluated IBD patients, 130 (18.9%) were identified as being at risk of malnutrition. Patients without MASLD (n = 89 [68.5%]) were more likely to be at risk than those with MASLD (n = 41 [31.5%], p = 0.005). However, among patients at risk of malnutrition, those with MASLD were more likely to have active IBD (82.9%) than patients without MASLD (39.3%, p < 0.001). Female sex (OR 1.984, p = 0.027) and young age (OR 1.014, p = 0.006) were associated with malnutrition risk only in patients with IBD without MASLD. Being at risk of malnutrition was associated with worse quality of life (p < 0.001), especially in IBD patients with MASLD.

CONCLUSIONS

Malnutrition risk and quality of life are modified by the presence of MASLD in IBD patients.

摘要

背景

代谢功能障碍相关脂肪性肝病（MASLD）与营养不良风险可能并存于炎症性肠病（IBD）患者中。我们对IBD患者进行了营养不良风险评估，作为其标准随访的一部分，并根据是否存在MASLD研究了营养不良风险的潜在危险因素。

方法

使用营养不良通用筛查工具（MUST）筛查营养不良风险（MUST≥1），并使用受控衰减参数（CAP≥248 dB/min）评估MASLD。还评估了对地中海饮食的依从性、身体活动和生活质量。

结果

在686例接受评估的IBD患者中，130例（18.9%）被确定存在营养不良风险。无MASLD的患者（n = 89 [68.5%]）比有MASLD的患者（n = 41 [31.5%]，p = 0.005）更易出现营养不良风险。然而，在有营养不良风险的患者中，有MASLD的患者比无MASLD的患者更易患有活动期IBD（82.9% 对39.3%，p < 0.001）。仅在无MASLD的IBD患者中，女性（OR 1.984，p = 0.027）和年轻（OR 1.014，p = 0.006）与营养不良风险相关。存在营养不良风险与较差的生活质量相关（p < 0.001），尤其是在有MASLD的IBD患者中。