Unveiling hidden malnutrition in IBD: A cross-sectional multi-tool analysis reveals high prevalence beyond...

Malnutrition is a serious complication of inflammatory bowel disease (IBD), associated with increased morbidity, postoperative complications, and reduced quality of life. While well-documented in Western populations, data on nutritional status in understudied IBD populations remain scarce. This study aims to comprehensively evaluate the nutritional status of an IBD cohort at a tertiary referral center in Algeria using multiple assessment tools, to identify factors associated with malnutrition, and to explore the relationship between inflammatory activity and nutritional parameters.

A prospective cross-sectional study was conducted at a tertiary referral center. Nutritional assessment included anthropometric measurements, biochemical parameters, and four validated scores: CONUT, McClave, HALP, and GLIM criteria. Disease activity was assessed using the Harvey-Bradshaw Index for Crohn's disease and the Partial Mayo Score for ulcerative colitis.

Ninety patients were included forming a Crohn's-dominant cohort (94.4% Crohn's disease). Mean age was 39.5±13.7 years, 53.3% female. Overall, 24.4% had active disease. Nutritional assessment revealed: 18.9% had low BMI (<18.5kg/m²). Malnutrition prevalence varied by tool: CONUT 46.7%, McClave 20.6%, HALP 26.8%, and GLIM 14.6%. Active disease significantly correlated with nutritional deterioration and worse nutritional scores (p<0.01). Multivariate logistic regression analysis was performed indicates that although clinical flare and hospitalization were associated with malnutrition in univariate analysis, none of the variables reached statistical significance in the multivariate analysis.

Malnutrition is highly prevalent in IBD patients, particularly during active disease. The inflammatory process plays a crucial role in nutritional deterioration. Systematic nutritional screening using composite scores should be integrated into routine management, especially during disease flares.