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P274. Body composition measurement among IBD patients

A.A. Csontos1, A. Molnar2, K. Lorinczy1, D. Kocsis1, M. Juhasz1, K. Mullner1, L. Herszenyi1, P. Miheller1, 1Semmelweis University, 2nd Department of Medicine, Budapest, Hungary, 2Hungarian Crohn and Colitis Association, Hungarian Crohn and Colitis Association, Budapest, Hungary

Background

Many patients with inflammatory bowel disease (IBD) are affected by low body mass and moreover altered fat and fat free mass distribution. These factors cannot be detected by routine clinical assessment. Abnormal body composition may affect illness outcome, quality of life and may lead to even more complications. The bioelectrical impedance analysis (BIA) is a widely used method to examine body composition.

Methods

We included 121 patients with Crohn's disease (CD) and 52 with ulcerative colitis (UC). High quality body analyzer (InBody 720, using 6 different frequencies 5 body segments) was used to assess the body weight, body mass index (BMI), body fat percent, skeletal muscle mass (SMM), fat free mass (FFM), visceral fat area (VFA), body water content (TBW). 100 age and gender matched healthy individuals (HC) were included as a control.

Results

16.2% (n = 28) of the patients was had low BMI (<18.5), 3.5% of them (n = 6) had BMI < 16. 55.5% (n = 45) of patients with normal BMI had low muscle mass, 33.3% (n = 27) had decreased and 58.0% (n = 47) increased body fat. Patients with IBD had lower FFM (53.16±11.76 vs. 56.92±14.06, p < 0.01), SMM (29.38±7.28 vs. 31.95±8.49, p < 0.01) VFA (98.61±53.89 vs. 79.23±47.06, p < 0.01) and TBW (39.09±8.65 vs. 41.71±10.3, p < 0.01) compared to HC. These results were not differed in CD vs. UC patients. Patients with inflammatory type had significantly less FFM (51.58±12.11 vs. 55.46±10.66; p < 0.05) and TBW (40.75±7.83 vs. 37.92±8.89, p < 0.05) compared to patients with penetrating type CD. They also had significantly lower FFM, SMM and TBW content than healthy controls (51.58±12.11 vs. 56.92±0.40, p < 0.01; 28.25±7.63 vs. 31.95±8.49, p < 0.005; 37.92±8.89 vs. 41.74±10.30, p < 0.05; respectively). We found no significant difference between body compositions of CD patients depending on disease location. These parameters did not varied in UC with different location. Patients were divided into 3 groups based on their efficacious maintenance medications (mesalazine, azathioprine, biological). FFM, SMM, TBW in patients using immunosuppressive therapy was significant better than patient using ASA in UC (58.55±12.71 vs. 49.78±12.21, p < 0.05; 32.82±7.43 vs. 27.47±7.52, p < 0.05; and 43.22±9.90 vs. 36.62±8.94, p < 0.05; respectively). Significant correlation was detected between disease duration and BMI (r = 0.036), SMM (r = 0.046) and body fat percent in CD patients (r = 0.045).

Conclusion

According to our findings, IBD patients' body composition differed from HC. The results suggest that BMI is not a sufficient parameter to estimate body composition. BIA seems to be more informative regarding nutritional status than routine clinical methods, and it may play a role in IBD patient care in the future.