Arshdeep Singh, MD

New data links patients with inflammatory bowel disease (IBD) to an increased risk of malnutrition and sarcopenia.

A team, led by Arshdeep Singh, MD, Department of Gastroenterology, Dayanand Medical College and Hospital, evaluated the nutritional status of patients with IBD and determined the threshold values of different parameters of nutritional assessment to identify malnutrition.

The Study

In the single-center cross-sectional analysis, the investigators examined adult patients with IBD who underwent anthropometry [body mass index (BMI), mid upper arm circumference (MUAC) and triceps-fold thickness (TSF)], body composition analysis and assessment for sarcopenia [hand-grip strength and skeletal muscle index (SMI) at L3 vertebral level)].

They also matched each participant with a control group by age and gender matched. The team also defined malnutrition by the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria.

Overall, there were 406 patients with IBD included in the analysis, 82.76% (n = 336) of which were diagnosed with ulcerative colitis and 17.24% (n = 70) of which were diagnosed with Crohn’s disease. The mean age of this patient population was 40.56 ± 13.67 years.

The study also included 100 healthy control patients with a mean age of 38.69 ± 10.90 years.

Results

The BMI, MUAC, TSF thickness, fat and lean mass, hand-grip strength, and SMI at L3 vertebral level were lower in patients with IBD compared to the healthy control group.

Malnutrition rates were similar between patients with ulcerative colitis and patients with Crohn’s disease. In the ulcerative colitis subgroup, 24.40% (n = 82) were diagnosed with malnutrition, while 28.57% (n = 20) of the Crohn’s disease subgroup were diagnosed with malnutrition.

The cutoff values of MUAC and TSF thickness to identify malnutrition were 23.25 cm and 25.25 cm in female patients, respectively, and 16.50 mm and 8.50 mm in male patients, respectively.

“Malnutrition and sarcopenia were common in patients with IBD, with the prevalence being similar in patients with both UC and CD,” the authors wrote.

Malnutrition and IBD

In new research presented during the 2022 European Crohn’s and Colitis Organisation annual meeting, investigators identified predictors for malnutrition in patients with IBD.

A team, led by Evelien Hendrix, PhD, Maastricht University, School for Nutrition and Translational Research in Metabolism NUTRIM, assessed the prevalence of malnutrition and evaluated the accuracy of screening recommendations given in current IBD guidelines and identified which patients have an increased risk of malnutrition.

Of the 200 patients, 20.5% (n = 41) fulfilled the GLIM criteria and 47.5% (n = 95) had at least one parameter for malnutrition impaired, the majority of which was for the fat free mass index measure.

When the investigators used unintentional weight loss and/or low BMI as a screening marker for nutritional status in line with current IBD guidelines, only 14.5% (n = 29) of patients would have been identified.

However, using the SNAQ technique for screening, the investigators identified 22% (n = 44) with a positive score, compared to 12.9% (n = 23) using the MUST technique.

For gender, only female sex was linked to malnutrition when at least 1 parameter was impaired (OR, 2.47; 95% CI, 1.35-4.51).

The study, “Evaluation of Nutritional Characteristics Reveals Similar Prevalence of Malnutrition in Patients with Ulcerative Colitis and Crohn’s Disease,” was published online in Digestive Diseases and Sciences.