Body impedance analysis to estimate malnutrition in inflammatory bowel disease patients – A cross‐sectional study

Abstract

Objective: Malnutrition is a common clinical problem in patients with inflammatory bowel diseases (IBD). However, a gold standard for the detection of malnutrition in IBD patients is lacking.Methods: A cross-sectional study to assess malnutrition in patients with IBD and healthy controls (HCs). Clinical characteristics (Montreal classification, disease activity, previous surgery) and mutations in the NOD2 gene in patients with Crohn's disease (CD) were obtained. We performed a nutritional assessment with screening for nutritional risk and diagnosis for malnutrition (Malnutrition Universal Screening Tool [MUST]) score, NRS-2002, European Society for Clinical Nutrition and Metabolism (ESPEN), and Global Leadership Initiative on Malnutrition (GLIM) criteria and performed body impedance analysis (BIA). Results: 101 IBD patients (57 CD and 44 ulcerative colitis (UC) and 50 HC were included in a single northern German tertiary center. GLIM criteria detected malnutrition significantly more often compared to the ESPEN criteria. Active disease, a longstanding disease course, and previous surgery were associated with reduced muscle mass. IBD patients had a higher fat mass index compared to HC. Mutations in the NOD2 gene had no effect on nutritional status. Conclusions:The GLIM criteria detect malnutrition at a higher rate compared to ESPEN. Specific disease factors might put IBD patients at a higher risk for the development of malnutrition, so these patients might benefit from a frequently performed screening, which might result in a favorable disease course. | INTRODUCTIONInflammatory bowel disease (IBD) is a group of disorders of the alimentary tract that mainly consist of two entities, Crohn's disease (CD) and ulcerative colitis (UC). 1 While the pathogenesis of IBD is still not completely understood, it is well known that inappropriate activation of the mucosal immune system is caused by intestinal microbiota in patients with genetic risk profile 1-4 such as mutation in the NOD2 gene. 5-7 A broader evaluation of potential individual patient needs involves estimation of malnutrition, which is a common phenomenon in IBD and may present in 20%-70% of CD or UC patients. [8][9][10][11] However, it is more common in CD. 12 In IBD, disturbed digestion may interfere with absorption and trigger malnutrition. In turn, malnutrition may also negatively influence the disease