炎症性肠病住院患者营养状况的人体成分生物电阻抗分析比较研究

Bioelectrical Impedance Analysis for Body Composition and Nutritional Status in Hospitalized Patients With Inflammatory Bowel Disease

背景:炎症性肠病(IBD)累及消化道,患者营养不良患病率高。生物电阻抗分析(BIA)近年来被越来越多地应用于临床营养评估。目的:以BIA结合血清学指标分析住院IBD患者的营养状况。方法:回顾性纳入2015年1月—12月在上海交通大学医学院附属仁济医院住院治疗且进行BIA的IBD患者,共198例患者纳入研究,其中克罗恩病(CD) 129例,溃疡性结肠炎(UC) 69例。对CD与UC患者的血清学指标、BIA参数及其相关指数进行比较。结果:CD患者血清维生素B_(12)水平、体质量和体脂量显著低于UC患者(P <0. 05),低体质量者占比显著高于UC患者(P <0. 05)。男性CD患者血清胆固醇水平、体脂百分比、体质指数(BMI)、无脂体质量指数(FFMI)、体细胞质量指数(BCMI)、骨骼肌质量指数(SMMI)显著低于男性UC患者(P <0. 05),女性CD与UC患者间上述指标无明显差异(P>0. 05)。活动期与缓解期CD患者BMI、BCMI无明显差异(P>0. 05)。结论:IBD住院患者中,男性CD患者营养状况差于男性UC患者;除血清维生素B12外,女性CD与UC患者营养状况无明显差异。BIA指数能有效评估营养状况,可作为BMI的补充。

Background:Inflammatory bowel disease(IBD)affects the digestive tract,and the prevalence of malnutrition is high.Recently,bioelectrical impedance analysis(BIA)has been frequently used clinically for nutritional assessment.Aims:To study the nutritional status of hospitalized IBD patients through BIA combined with serological indicators.Methods:Data from hospitalized IBD patients who underwent BIA test at Renji Hospital,School of Medicine,Shanghai Jiao Tong University between Jan.and Dec.2015 were collected retrospectively.In the 198 patients enrolled,129 were Crohn’s disease(CD)and 69 were ulcerative colitis(UC).Serological results,as well as BIA results and related indices were compared between CD and UC patients.Results:The serum vitamin B 12 level,body weight and body fat mass were significantly lower in patients with CD than in those with UC(P<0.05),while the prevalence of underweight was significantly higher in CD patients than in UC patients(P<0.05).The serum cholesterol level,body fat percent,body mass index(BMI),fat free mass index(FFMI),body cell mass index(BCMI)and skeletal muscle mass index(SMMI)were significantly lower in male CD patients than in male UC patients(P<0.05),whereas no significant differences in these parameters were observed between female CD and female UC patients(P >0.05).Differences in BMI and BCMI between active CD and CD in remission were insignificant(P >0.05).Conclusions:Among the hospitalized IBD patients,males with CD have worse nutritional status than males with UC.Except for serum vitamin B12,there is no significant difference in nutritional status between female CD and female UC patients.BIA related indices are effective tool for assessment of nutritional status,which may be used as a complement to BMI.