Original articleNutritional status in patients with active inflammatory bowel disease: Prevalence of malnutrition and methods for routine nutritional assessment
Section snippets
Background
Undernutrition has been often reported in patients with inflammatory bowel disease (IBD), particularly in patients with active Crohn's disease (CD) [1], [2], [3], [4], [5]. Furthermore, the presence of malnutrition has been linked to adverse outcomes [2], [4]. The aetiology of malnutrition in patients with IBD is multifactorial, and the nutritional status is the result of complex pathophysiological processes [6], [7], [8], [9], [10]; these include poor nutritional intake due to postprandial
Materials and methods
Seventy-six consecutive patients with active IBD from the Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, were included in the study. Written informed consent was obtained from each subject. Fifty-three patients with UC, aged 42.31 ± 15.42 years, (range, 17.0–74.0 years) and 23 CD patients, aged 39.21 ± 15.47 years (range 19.0–74.0 years) entered the study protocol. Thirty healthy volunteers (14 men and 16 women) participated in this study as a control group. Subject
Results
Fifty-two (68.4%) IBD patients with active disease, meet the criteria for malnutrition according to data of unintentional weight loss [24 (31.6%) were severely malnourished], while in controls unintentional weight loss was not detected (χ² test, p < 0.01). In malnourished IBD patients with active disease, 36 (67.9%) had UC and 16 (69.6%) had CD (χ² test, p > 0.05). The anthropometric parameters of nutrition: BW, BMI, TSF, BSF, SsSF, SiSF, percentage of body fat, MAC and MAMC were significantly
Discussion
The data regarding nutritional status in patients with IBD are inconsistent and inadequate to characterize it precisely. However, it is clear that malnutrition is a significant problem in IBD patients. In this study, the nutritional status was assessed by comprehensive anthropometric, as well as biochemical parameters and percentage of weight loss in the past 1 to 6 months. These methods were selected as they are widely available and suitable for routine use. We confirmed that undernutrition is
Learning points
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Malnutrition is common in patients with active CD and UC. In addition, substantial proportion of IBD patients with active disease is severely malnourished. Serum albumin and BMI are simple and convenient methods for routine assessment of nutritional status in patients with active IBD. Further studies with large subgroups of patients with IBD are necessary to define influencing factors, and the most accurate nutritional assessment methods.
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