eCONUT-UC for nutritional screening and malnutrition identification in ulcerative colitis

Detecting malnutrition in patients with ulcerative colitis is considered a clinical challenge. The Global Leadership Initiative on Malnutrition (GLIM) criteria constitute a standardized approach for diagnosis. However, the Controlling Nutritional Status (CONUT) score is a simple tool based on laboratory analysis; its performance in early malnutrition detection could be improved. Our aim was to exploratorily derive and assess the apparent diagnostic performance of enhanced CONUT-based scores (eCONUT-UC) for identifying GLIM-defined malnutrition in patients with ulcerative colitis.

We conducted a cross-sectional study in patients with ulcerative colitis. We measured weight, height, body mass index, and body composition using DXA and BIA. We extracted recent laboratory results and clinical data from medical records. We used the GLIM criteria as the reference standard for detecting malnutrition in ulcerative colitis. We evaluated the diagnostic performance of the eCONUT-UC by incorporating phase angle (PhA), hemoglobin (Hgb), and triglycerides (TG). We calculated sensitivity, specificity, and area under the curve (AUC).

We included 51 patients, of whom 15 (29%) met GLIM criteria for malnutrition. The original CONUT score had a sensitivity of 73% and a specificity of 67%. The eCONUT-UC-PhA and eCONUT-UC-Hgb showed a sensitivity of 80%, with an AUC of 0.741 [95% CI: 0.587-0.895] and 0.738 [95% CI: 0.586-0.890]. The eCONUT-UC-TG showed lower diagnostic performance.

The eCONUT-UC showed higher sensitivity in detecting malnutrition than the original CONUT. Its use as a rapid and accessible screening tool supports its potential implementation in clinical practice, particularly in resource-limited settings, to facilitate timely nutritional intervention for patients with ulcerative colitis.