Body composition in childhood inflammatory bowel disease
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Published on: September 22, 2019
Anthony E Wiskin1, Stephen A Wootton, Toby M Hunt
1NIHR Biomedical Research Unit (Nutrition, Diet & Lifestyle), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Insights
Children with Inflammatory Bowel Disease (IBD) show varied weight status, with nutritional deficits more prevalent in Crohn's disease. Fat-free mass is linked to disease activity, not just weight, in pediatric Crohn's disease.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Body Composition Analysis
Background:
- Impact of Inflammatory Bowel Disease (IBD) on pediatric growth patterns remains incompletely understood.
- While height and weight deficits are documented in pediatric Crohn's disease, changes in body composition (fat and fat-free mass) are less defined.
- This study addresses the need to characterize growth and body composition in children with IBD.
Purpose of the Study:
- To describe the height, weight, and body composition of a cohort of children diagnosed with Inflammatory Bowel Disease (IBD).
- To investigate the relationship between disease activity and body composition parameters in pediatric IBD patients.
Main Methods:
- Measurements included height, weight, skinfold thicknesses, and bioelectrical impedance analysis.
- Disease activity was quantified using established clinical scoring systems.
- Statistical analysis, including multiple regression, was employed to identify relationships between variables.
Main Results:
- The cohort comprised 55 children with a median age of 13.7 years.
- Median Standard Deviation Scores for BMI, height, and weight indicated a range of nutritional status within the cohort.
- In Crohn's disease, higher disease activity (PCDAI) was significantly associated with lower fat-free mass, independent of overall weight.
Conclusions:
- Children with IBD exhibit a spectrum of weight status, including both under- and overweight conditions.
- Nutritional deficits, particularly in fat-free mass, are more pronounced in pediatric Crohn's disease.
- Disease activity directly impacts lean body mass in pediatric Crohn's disease, highlighting that standard weight or BMI metrics may obscure underlying body composition changes.
Background & Aims:
Little is known about the impact of disease and treatment on the pattern of growth in children with Inflammatory Bowel Disease (IBD). Significant deficits in height and weight in children with Crohn's disease have been reported but changes in fat and fat free mass are less well defined. This study aims to describe the height, weight and body composition of a cohort of children with IBD.
Methods:
Height, weight, skinfold thicknesses and bioelectrical impedance analysis was performed. Disease activity was assessed with clinical scoring systems.
Results:
55 children, median age 13.7 years (range 6.5-17.7) were studied. Median (25th, 75th percentile) Standard Deviation Score for BMI, Height and Weight were - 0.3 (- 0.97, 0.65), - 0.56 (- 1.42, 0.06), - 0.62 (- 1.43, 0.19). In Crohn's disease, using multiple regression analysis disease activity measured by PCDAI was significantly inversely related to fat free mass (β - 0.2, 95% CI -0.17, -0.03, p 0.005).
Conclusions:
Children with IBD were both under and overweight. Nutritional deficits were more common in Crohn's disease. Fat free mass was related to disease activity in children with Crohn's disease regardless of changes in weight. Weight or BMI may mask deficits in lean tissue in the presence of normal or increased proportions of body fat.
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