活动期溃疡性结肠炎患者体成分变化特点及其与临床结局的相关性探究

The investigation on body composition in patients with active ulcerative colitis and its correlation with clinical outcome

目的通过生物电阻抗分析测定溃疡性结肠炎(ulcerative colitis,UC)患者体成分,探究体成分指标与患者病情活动度、实验室指标、反复住院的关系。方法连续纳入北京协和医院消化内科住院治疗的活动期UC患者,并通过海报招募与患者年龄、性别比例相匹配的健康志愿者。以生物电阻抗分析法测量受试者体成分,并用身高(m)平方校正四肢、躯干骨骼肌量,分别计算四肢骨骼肌量指数(appendicular skeletal muscle index,ASMI)和躯干骨骼肌量指数(trunk skeletal muscle index,TSMI)。以握力评价受试者肌肉功能。并统计随访期内患者是否因病情加重或反复而再次住院。结果研究纳入UC组62例、健康对照组38例。UC组男性患者TSMI较健康对照组显著减低(P<0.001),而ASMI与健康对照组比较差异无统计学意义;女性患者ASMI(P<0.001)、TSMI(P=0.002)均较健康对照组显著减低。与TSMI正常患者相比,TSMI减低患者中病情重度活动者比例有升高趋势(P=0.075),在ASMI减低患者中未观察到此现象。UC组握力、相位角均与白蛋白显著正相关(P均<0.05)。相位角减低患者的再住院率显著高于相位角正常患者(58.3%比22.0%,P=0.040)。结论UC患者体成分存在异常且具有性别差异。在UC患者中,与ASMI相比,TSMI可能更具有临床意义。低相位角对患者反复住院可能具有预测价值。

ObjectiveTo evaluate the body composition of ulcerative colitis(UC)patients by bioelectrical impedance analysis(BIA)and explore the correlation between body composition indices and disease activity,laboratory indices,and readmission.MethodsPatients with active UC hospitalized in the Department of Gastroenterology of Peking Union Medical College Hospital were enrolled continuously,and age and sex ratio-matched healthy volunteers were recruited through recruitment posters.Body composition was measured via BIA.Appendicular skeletal muscle index(ASMI)and trunk skeletal muscle index(TSMI)were calculated and adjusted for height(m 2).Muscle function was evaluated via handgrip strength.Moreover,patients were followed up after discharge and the readmissions due to recurrence or aggravation of UC were recorded.ResultsThis study enrolled 62 UC patients and 38 healthy volunteers.TSMI decreased significantly(P<0.001)while ASMI showed no significant difference in male patients compared with healthy controls.ASMI(P<0.001)and TSMI(P=0.002)in female patients were significantly lower than those in healthy controls.Compared with patients with normal TSMI,a larger proportion of patients with low TSMI tended to show severe disease activity(P=0.075),while no such trend was observed in patients with low ASMI.Handgrip strength and phase angle were significantly positively correlated with ALB in UC patients(P<0.05).The proportion of patients with readmission was significantly higher in the low phase angle group than that in the normal phase angle group(58.3%vs.22.0%,P=0.040).ConclusionsThere were abnormal body composition and gender differences in UC patients.TSMI correlated better with clinical characteristics than ASMI in UC patients.Low phase angle might be predictive for readmission in UC patients.