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Abstract：
Malnutrition and subsequent alterations in body composition (BC), particularly sarcopenia, are common but not yet elucidated in patients with inflammatory bowel disease (IBD); we aimed to detail the changes in BC and the characteristics of co-occurrence of malnutrition and sarcopenia in IBD patients and to investigate its effect on quality of life.
This study was a multicentre, prospective, observational study involving four tertiary referral hospitals in China. The following data were collected from consecutive IBD inpatients: demographic information, medical history, recent weight change, handgrip strength (HGS) and BC parameters by bioelectrical impedance analysis (BIA). Nutritional assessments were performed through stepwise screening (Nutritional Risk Screening 2002) and diagnosis (World Health Organization-related body mass index [BMI], subjective global assessment, European Society for Clinical Nutrition and Metabolism 2015 and Global Leadership Initiative on Malnutrition [GLIM] criteria). The quality of life was assessed by the Inflammatory Bowel Disease Questionnaire. IBD patients were compared with 1:1 sex-, age- and BMI-matched healthy controls (MHC).
A total of 238 IBD patients (177 Crohn\'s disease [CD] and 61 ulcerative colitis [UC]), 68.5% male, with a mean age of 38.5 ± 14.0 years and a mean BMI of 19.8 ± 3.5 kg/m2 , were recruited. Compared with MHC (n = 122), IBD patients showed significant deterioration in BC and physical function, characterized by muscle depletion (appendicular skeletal muscle mass index [ASMI], 8.0 ± 1.3 vs. 6.7 ± 1.2 kg/m2 , Δ% -15.0% [-22.0%, -10.0%], P < 0.001) and fat accumulation (visceral fat area, 32.9 ± 22.6 vs. 66.5 ± 35.8, Δ% 110.0% [35.0%, 201.0%], P < 0.001). The prevalence of GLIM-defined malnutrition and sarcopenia in IBD patients was 60.1% and 25.2%, respectively. The nutritional status of patients with CD was worse than that of patients with UC. The activity phase of IBD significantly and negatively affected BC, while the lesion location did not. The co-occurrence of sarcopenia and malnutrition was not optimistic; 16.4-21.8% of patients suffer from sarcopenia and malnutrition based on different criteria at the same time, which was accompanied by a reduction in quality of life. HGS was correlated with various BC parameters (body cell mass, r = 0.76; ASMI, r = 0.70; fat-free mass, r = 0.73, all P < 0.001).
GLIM-defined malnutrition and sarcopenia were prevalent in IBD patients and kept a high rate of co-occurrence, which was accompanied with impaired quality of life. The alteration of BC in IBD patients was characterized by muscle depletion and fat accumulation. The strong correlation between HGS and BIA-derived BC suggested its hopeful evaluation in nutritional status and sarcopenia in IBD patients.
This study was a multicentre, prospective, observational study involving four tertiary referral hospitals in China. The following data were collected from consecutive IBD inpatients: demographic information, medical history, recent weight change, handgrip strength (HGS) and BC parameters by bioelectrical impedance analysis (BIA). Nutritional assessments were performed through stepwise screening (Nutritional Risk Screening 2002) and diagnosis (World Health Organization-related body mass index [BMI], subjective global assessment, European Society for Clinical Nutrition and Metabolism 2015 and Global Leadership Initiative on Malnutrition [GLIM] criteria). The quality of life was assessed by the Inflammatory Bowel Disease Questionnaire. IBD patients were compared with 1:1 sex-, age- and BMI-matched healthy controls (MHC).
A total of 238 IBD patients (177 Crohn\'s disease [CD] and 61 ulcerative colitis [UC]), 68.5% male, with a mean age of 38.5 ± 14.0 years and a mean BMI of 19.8 ± 3.5 kg/m2 , were recruited. Compared with MHC (n = 122), IBD patients showed significant deterioration in BC and physical function, characterized by muscle depletion (appendicular skeletal muscle mass index [ASMI], 8.0 ± 1.3 vs. 6.7 ± 1.2 kg/m2 , Δ% -15.0% [-22.0%, -10.0%], P < 0.001) and fat accumulation (visceral fat area, 32.9 ± 22.6 vs. 66.5 ± 35.8, Δ% 110.0% [35.0%, 201.0%], P < 0.001). The prevalence of GLIM-defined malnutrition and sarcopenia in IBD patients was 60.1% and 25.2%, respectively. The nutritional status of patients with CD was worse than that of patients with UC. The activity phase of IBD significantly and negatively affected BC, while the lesion location did not. The co-occurrence of sarcopenia and malnutrition was not optimistic; 16.4-21.8% of patients suffer from sarcopenia and malnutrition based on different criteria at the same time, which was accompanied by a reduction in quality of life. HGS was correlated with various BC parameters (body cell mass, r = 0.76; ASMI, r = 0.70; fat-free mass, r = 0.73, all P < 0.001).
GLIM-defined malnutrition and sarcopenia were prevalent in IBD patients and kept a high rate of co-occurrence, which was accompanied with impaired quality of life. The alteration of BC in IBD patients was characterized by muscle depletion and fat accumulation. The strong correlation between HGS and BIA-derived BC suggested its hopeful evaluation in nutritional status and sarcopenia in IBD patients.
摘要：
背景：营养不良和随后的身体组成（BC）改变，尤其是少肌症,在炎症性肠病（IBD）患者中很常见，但尚未阐明；我们旨在详细介绍IBD患者BC的变化以及营养不良和肌肉减少症的并发特征，并研究其对生活质量的影响。
方法：这项研究是一个多中心，prospective,涉及中国四家三级转诊医院的观察性研究。以下数据来自连续的IBD住院患者：人口统计信息，病史,最近的体重变化，通过生物电阻抗分析（BIA），握力（HGS）和BC参数。通过逐步筛查（营养风险筛查2002）和诊断（世界卫生组织相关的体重指数[BMI]，主观全局评估，2015年欧洲临床营养与代谢学会和全球营养不良领导力倡议[GLIM]标准）。通过炎症性肠病问卷评估生活质量。IBD患者与1：1性别相比，年龄和BMI匹配的健康对照（MHC）。
结果：共238例IBD患者（177例克罗恩病[CD]和61例溃疡性结肠炎[UC]），68.5%男性,平均年龄为38.5±14.0岁，平均BMI为19.8±3.5kg/m2，被招募。与MHC（n=122）相比，IBD患者表现为BC和身体功能的显著恶化，以肌肉耗竭为特征(阑尾骨骼肌质量指数[ASMI]，8.0±1.3vs.6.7±1.2kg/m2,Δ%-15.0%[-22.0%，-10.0%]，P<0.001)和脂肪堆积(内脏脂肪面积，32.9±22.6vs.66.5±35.8，Δ%110.0%[35.0%，201.0%]，P<0.001)。IBD患者中GLIM定义的营养不良和肌少症的患病率分别为60.1%和25.2%,分别。CD患者的营养状况比UC患者差。IBD的活动期对BC有显著的负面影响，而病变位置没有。肌肉减少症和营养不良的同时发生情况不容乐观;16.4-21.8%的患者同时根据不同的标准患有肌肉减少症和营养不良,伴随着生活质量的下降。HGS与各种BC参数(身体细胞质量，r=0.76;ASMI,r=0.70；无脂质量，r=0.73,均P<0.001)。
结论：GLIM定义的营养不良和肌少症在IBD患者中普遍存在，并保持较高的合并率，伴随着生活质量受损。IBD患者的BC改变以肌肉消耗和脂肪积累为特征。HGS与BIA衍生的BC之间的强相关性表明其对IBD患者的营养状况和肌肉减少症的评估充满希望。
方法：这项研究是一个多中心，prospective,涉及中国四家三级转诊医院的观察性研究。以下数据来自连续的IBD住院患者：人口统计信息，病史,最近的体重变化，通过生物电阻抗分析（BIA），握力（HGS）和BC参数。通过逐步筛查（营养风险筛查2002）和诊断（世界卫生组织相关的体重指数[BMI]，主观全局评估，2015年欧洲临床营养与代谢学会和全球营养不良领导力倡议[GLIM]标准）。通过炎症性肠病问卷评估生活质量。IBD患者与1：1性别相比，年龄和BMI匹配的健康对照（MHC）。
结果：共238例IBD患者（177例克罗恩病[CD]和61例溃疡性结肠炎[UC]），68.5%男性,平均年龄为38.5±14.0岁，平均BMI为19.8±3.5kg/m2，被招募。与MHC（n=122）相比，IBD患者表现为BC和身体功能的显著恶化，以肌肉耗竭为特征(阑尾骨骼肌质量指数[ASMI]，8.0±1.3vs.6.7±1.2kg/m2,Δ%-15.0%[-22.0%，-10.0%]，P<0.001)和脂肪堆积(内脏脂肪面积，32.9±22.6vs.66.5±35.8，Δ%110.0%[35.0%，201.0%]，P<0.001)。IBD患者中GLIM定义的营养不良和肌少症的患病率分别为60.1%和25.2%,分别。CD患者的营养状况比UC患者差。IBD的活动期对BC有显著的负面影响，而病变位置没有。肌肉减少症和营养不良的同时发生情况不容乐观;16.4-21.8%的患者同时根据不同的标准患有肌肉减少症和营养不良,伴随着生活质量的下降。HGS与各种BC参数(身体细胞质量，r=0.76;ASMI,r=0.70；无脂质量，r=0.73,均P<0.001)。
结论：GLIM定义的营养不良和肌少症在IBD患者中普遍存在，并保持较高的合并率，伴随着生活质量受损。IBD患者的BC改变以肌肉消耗和脂肪积累为特征。HGS与BIA衍生的BC之间的强相关性表明其对IBD患者的营养状况和肌肉减少症的评估充满希望。
