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P191 Lower values of skeletal muscle index measured by bioelectrical impedance in active IBD patients

D. Vranesic Bender1,2, V. Domislović3, A. Barišić3, I. Karas1, D. Ljubas Kelečić1, M. Brinar3,4, N. Turk3, Ž. Krznarić3,4

1Unit for Clinical Nutrition, Department of Gastroenterology and Hepatology, Zagreb, Croatia, 2Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia, 3Department of Gastroenterology and Hepatology, Clinical Hospital Centre Zagreb, Zagreb, Croatia, 4Zagreb School of Medicine, University of Zagreb, Zagreb, Croatia

Background

Inflammatory bowel disease (IBD) is commonly associated with alteration in fat and lean mass. Body mass index (BMI) is not a prime index for assessing nutritional status, while a better way to evaluate it would be to bioimpedance analysis. In addition, correlation of body composition with disease severity has not been well studied. The aim of this study was to evaluate the association of body composition and muscle strength with disease activity in adult patients with Crohn’s disease (CD) and ulcerative colitis (UC).

Methods

All patients underwent the analysis of body composition measured by bioelectrical impedance analysis (TANITA body composition analyser, BC-420MA). Lean mass (LM), fat-free mass index (FFMI) and skeletal muscle index (SMI) were calculated using standard formulae. Muscle strength was obtained from handgrip strength values (HS) measured with Jamar Hydraulic Hand Dynamometer. Medical history data were obtained from clinical and electronic medical records. Active disease was defined as Crohn’s disease Activity Index (CDAI) >150 for CD and Partial Mayo Score ≥3 for UC patients. Underweight patients were defined as BMI<18.5 kg/m2.

Results

In this study we have enrolled 120 patients (CD = 86, UC = 34; 65% male). Average age was 37.5 (35.3–39.6). Clinically active disease was present in 23 patients (19.1%), CD (n = 15), UC (n = 8). There were no statistically significant differences among patients with active and inactive disease in FFMI (kg/m2) 17(15–19.8) vs. 18.5 (15.7–20.3), p = 0.18, LM (kg) 56.5 (44.3–65.1) vs. 48.3 (43–67.2), p = 0.21, fat mass (%) 16 (11.5–23) vs. 11.8 (7.9–21), p = 0.14, and MS 33.3( ± 11.5) vs. 28.3 ( ± 9.9), p > 0.05. The SMI (kg/m2) was significantly lower in patients with active disease comparing to group with inactive disease 8.1(7.7–9.9) vs. 10(8.6–10.6), p = 0.032. Underweight patients were significantly more prevalent in active group comparing to inactive (30.4% vs. 6.4%, p = 0.0011).

Conclusion

IBD patients with active disease have lower skeletal muscle index, while there was no difference in other components of body composition. In addition, underweight patients have a significantly higher proportion of active disease. Body composition analysis by BIA could be a useful tool in the evaluation of patients with inflammatory bowel diseases; however, there is a need to define age-, gender- and disease-specific, percentile-based thresholds specifically for patients with IBD, which can simplify the screening procedures in clinical practice, and suggest nutritional intervention.