Bezzio Cristina, Brinch Daniele, Ribaldone Davide Giuseppe, Cappello Maria, Ruzzon Natalie, Vernero Marta, Scalvini Davide, Loy Laura, Donghi Sofia, Ciminnisi Stefania, Manes Gianpiero, Armuzzi Alessandro, Saibeni Simone
IBD Centre, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy.
Nutrients. 2024 Nov 21;16(23):3983. doi: 10.3390/nu16233983.
The prevalences of malnutrition and sarcopenia in patients with IBD are not precisely known, and nutritional assessment is not standardized. We assessed the prevalence and risk factors of these conditions in outpatients and their impact on clinical outcomes.
This prospective longitudinal study considered patients who had IBD for at least one year, were attending a tertiary IBD center, and were followed for the subsequent year.
In a sample of 158 consecutive patients (96 with Crohn's disease and 62 with ulcerative colitis), the prevalence of malnutrition, according to GLIM criteria, was 13.3%. For identifying patients at risk of malnutrition, the Malnutrition Universal Screening Tool demonstrated better accuracy, (sensitivity 88.9 (65.3-98.6) and specificity 90.2 (83.8-93.4)) than the SaskIBD-NR questionnaire (sensitivity 69.3 (41.1-86.7) and specificity 60.9 (60.9-76.8)). The prevalence of sarcopenia was 34.2%. Considering clinical outcomes, sarcopenia at baseline was significantly associated with hospital admission within a year ( = 45.2% vs. 20.3%, 0.026).
Malnutrition and sarcopenia were present in about one-third of IBD patients. Awareness should be raised among physicians caring for IBD patients about the need to evaluate patients' nutritional statuses to help patients achieve a better quality of life.
炎症性肠病(IBD)患者中营养不良和肌肉减少症的患病率尚不清楚,且营养评估未标准化。我们评估了这些情况在门诊患者中的患病率、危险因素及其对临床结局的影响。
这项前瞻性纵向研究纳入了患有IBD至少一年、在三级IBD中心就诊且随后一年接受随访的患者。
在连续的158例患者样本中(96例克罗恩病患者和62例溃疡性结肠炎患者),根据全球营养不良领导倡议(GLIM)标准,营养不良的患病率为13.3%。对于识别有营养不良风险的患者,营养不良通用筛查工具显示出比萨斯喀彻温IBD营养风险问卷(SaskIBD-NR)更高的准确性(敏感性88.9(65.3 - 98.6),特异性90.2(83.8 - 93.4)),而SaskIBD-NR问卷的敏感性为69.3(41.1 - 86.7),特异性为60.9(60.9 - 76.8)。肌肉减少症的患病率为34.2%。考虑临床结局,基线时的肌肉减少症与一年内住院显著相关(45.2%对20.3%,P = 0.026)。
约三分之一的IBD患者存在营养不良和肌肉减少症。应提高诊治IBD患者的医生对评估患者营养状况必要性的认识,以帮助患者获得更好的生活质量。