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P731 Characteristics and follow-up on body composition, physical activity and quality of life in paediatric patients with inflammatory bowel disease

K. K. Boros*1, O. Cseprekál2, K. E. Müller3, A. Dezsőfi1, G. Reusz1, G. Veres3

1Semmelweis University, Ist Department of Paediatrics, Budapest, Hungary, 2Semmelweis University, Ist Department of Medicine, Budapest, Hungary, 3University of Debrecen, Paediatric Institute-Clinic, Debrecen, Hungary

Background

Paediatric inflammatory bowel disease (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC) is associated with malnutrition and weight loss affecting body composition (BC). Characteristic symptoms of IBD are abdominal pain, arthralgia and fatigue leading to impaired physical activity (PA), affecting muscle, bone strength and quality of life (QoL). According To the best our knowledge, there is no other follow-up study analysing BC, PA, and QoL, therefore the aim of this study was to characterise these parameters in newly diagnosed CD and UC patients, and to follow them for a 6 month long period of time.

Methods

BC, PA and QoL was detected in IBD patients (n = 57, range: 10–18 years). Our patients were divided into four groups: newly diagnosed CD patients (nCD: n = 20; mean age: 13.3 ± 2.2 years), newly diagnosed UC patients (nUC: n = 14; mean age: 13.6 ± 2.3 years), and CD (btCD: n = 12; mean age: 15.6 ± 2.5 years) and UC patients (btUC n = 11, mean age: 15 ± 3.6 years) receiving biologicals. BC, including fat-free mass (FFM), and body fat mass (BFM) and skeletal muscle mass (SMM) was measured via bioelectrical impedance, using the InBody 720 device. PA was assessed with the Physical Activity Questionnaire (PAQ) and QoL with the validated IMPACT-III questionnaire. Patients were measured at the time of the diagnosis (M0), after 2 months (M2) and after 6 months of the diagnosis (M6). According to healthy controls BC data (n = 307, mean age: 14.28 ± 2.1) FFM, BFM and SMM z-scores were calculated via the LMS method.

Results

BMI and FFM index (FMMI) increased between M0 and M2 in nCD group. Between M2 and M6 weight, BMI, FFMI and SMM index (SMMI) increased further. weight z-score, BMI z-score and FFM z-score also increased during the 6-month follow-up. In the nUC group BMI, weight, FFM SMMI and QoL was higher at M2 compared with M0. In btUC group, BMI, FFMI, weight z-score, BMI z-score and BFM z-score increased significantly between M2 and M6. According to weight z-score, BMI z-score and FFM z-score, the highest number of under- or malnourished children (under -1 score) were in nCD group (8/20, 8/20, 10/20). The lowest number of under- or malnourished children were in btCD group (weight: 1/12, BMI: 4/12, FFM: 1/12).

Conclusion

Our data suggest that nCD patients have the worst nutritional status, which improves in the first 6 months after diagnosis. Patients, with a longer disease course, had better nutritional status.