Metabolic features of inflammatory bowel disease in a remission phase of the disease activity

J Intern Med. 1998 May;243(5):339-47. doi: 10.1046/j.1365-2796.1998.00254.x.

Abstract

Objectives: To evaluate the anthropometric and metabolic characteristics of patients with Crohn's disease (CD) and ulcerative colitis (UC), comparing both groups with healthy volunteers.

Design: A cross-sectional study.

Setting: The Department of Internal Medicine, Catholic University Hospital, Rome, Italy.

Subjects: Thirty-four patients with biopsy-proven inflammatory bowel disease (18 CD; 16 UC) in clinical remission (SCDAI < 3 and Powell-Tuck index < 4) not receiving steroid therapy.

Interventions: All patients had a clinical examination.

Main outcome measures: Blood indicators of inflammation and nutritional status. Body composition was assessed by both anthropometry and bioimpedance and metabolic variables were measured by indirect calorimetry over a 60-90 min period.

Results: CD had a lower body weight than both controls (58.1 kg, range 41.5-71.0 vs. 66.4 kg, range 57.0-76.0; P < 0.001) and UC) 58.1 kg, range 41.5-71.0 vs. 69.6 kg, range 50.5-94.0; (P < 0.001). Fat-free mass (FFM) did not differ between the groups, whilst fat mass was significantly lower in CD than in UC (P < 0.05) and controls (P < 0.001). Normalizing the basal metabolic rate by FFM, a higher value was found in CD compared with UC (143 kJ kg-1) d-(-1), range 97.5-179 vs. 133 kJ kg-1 d-1, range 123-148; P < 0.05) and control subject 143 kj kg-1 d-1, range 97.5-179 vs. 134 kj kg-1 d-1, range 122-162; P < 0.05). The nonprotein respiratory quotient was significantly lower in CD compared to UC 0.80, range 0.73-0.84 vs. 0.84, range 0.79-0.91; P < 0.01) and controls (0.80, range 0.73-0.84 vs. 0.83, range 0.81-0.87; P < 0.001), with a consequently higher lipid oxidation rate in CD.

Conclusions: CD subjects showed a decreased fat mass and enhanced utilization of lipids compared with UC and controls. These data could be explained by the larger intestinal involvement and considered as a contribution to lipid tissue wasting in CD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Basal Metabolism
  • Body Composition
  • Body Mass Index
  • Calorimetry, Indirect
  • Case-Control Studies
  • Colitis, Ulcerative / blood
  • Crohn Disease / blood
  • Cross-Sectional Studies
  • Electric Impedance
  • Female
  • Humans
  • Inflammation
  • Inflammatory Bowel Diseases / blood*
  • Male
  • Nutritional Status
  • Oxidation-Reduction