ABSTRACT
Background: The alterations in the body composition (BC) in both the active and remission phase of Crohn’s disease (CD) are poorly characterized. Objective: To assess the BC of the patients with CD in active and remission phase, and compare with healthy controls (HC). Methods: BC was assessed by bioelectrical impedance analysis using Tanita TBF-215 leg to leg portable impedance analyzer in 123 patients with CD and 100 matched HC. Diet intake was assessed by 24 hours diet recall method. Results: The mean age of patients was 36.4+12.6 years and 56% were males. Patients in active phase as well as in remission phase had a lower BMI than HC (18.8+3.6 vs. 23.9+4.0; p=0.001 and 18.8+3.6 vs. 21.6+5.0; p=0.002). The fat mass (FM) in active phase was significantly lower than that in remission phase (8.2+5.9 vs. 13.4+10.6 kg; p=0.005) and HC (8.2+5.9 kg vs. 14.1+7.5 kg; p=0.001). FM did not differ between remission phase and HC. The fat free mass (FFM) of HC was significantly higher than that of both remission phase (48.9+7.4 kg vs. 43.3+10.4 kg; p=0.001) and active phase (48.9+7.4 kg vs. 40.7+8.5 kg; p=0.001). There was no difference in the FFM of patients in both phases; p=0.356. The intake of macronutrients was comparable between the two phases; however lower than that of HC. Conclusion: Both FM and FFM were depleted in the active phase, while only FFM was deficient in the remission phase of CD, indicating a poor recovery of lean mass in remission.
ABSTRACT
BACKGROUND AND AIM: Malnutrition is a common feature in patients with Crohn's disease (CD), which leads to frequent infections and poor prognosis. In view of the rising incidence of CD in India we planned this study to assess the nutritional status of patients with CD. METHODS: Nutritional status of 112 patients (mean age 35.9 [SD 11.7] years; 61 men) with CD was assessed by anthropometric, dietary and biochemical parameters. Patients were considered malnourished if 3 or more anthropometric parameters (% ideal body weight [IBW], % tricep skin fold [TSF], %mid upper arm circumference [MUAC], and % mid arm muscle circumference [MAMC], body mass index [BMI]) were abnormal. Dietary intake was assessed by a 24-hour dietary recall along with a semi-quantitative food frequency method. Eighty volunteers were taken as healthy controls (HC). RESULTS: At the time of assessment, 77 patients were in remission and 35 had active disease. The values of BMI, MUAC, TSF and mid arm fat area (MAFA) in patients were significantly lower than those in healthy controls. MAMC and mid arm muscle area (MAMA) of patients and controls were comparable. TSF (Rem vs HC = 10.4 [2.8-71] vs 16 [3-41]) and MAFA (Rem vs HC = 1236 [240-7757] vs 1858 [322-5650]) of the patients in the remission phase were significantly lower than those of healthy controls; the remaining parameters were comparable. There was no difference in the dietary intake of patients in the remission and active phases, and healthy controls. The percentage energy fulfillment of the patients was lower than that of healthy controls. Twenty-nine of 35 (82.8%) patients in the active and 30 of 77 (38.9%) patients in the remission phase were malnourished (OR 7.5, 95% CI 2.8-20.4). The overall prevalence of malnutrition was 52.6% among patients. CONCLUSION: The percentage of malnourished patients in the active and remission phases of the disease was 82.8% and 38.9%, respectively, possibly due to low percentage energy fulfillment.