P-090 Body Composition and Nutritional Evaluation of Patients with Inflammatory Bowel Disease

Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel diseases that progress with periods of activity and remission and compromise patients’ quality of life. Changes in nutritional status are related to mechanisms such as increased resting energy expenditure, inadequate food intake, increased losses and poor intestinal absorption. Nutritional status is related to the severity of the disease and complications may contribute to worst prognosis. The aim of this study was to perform a global assessment of nutritional condition and body composition, as well as a comparative analysis among patients with UC and DC treated at our outpatient unit. Patients were submitted to a clinical evaluation and nutritional assessment: body composition with bioelectrical impedance analysis and anthropometry. Parameters evaluated were: body mass index (BMI), mid-arm circumference (MAC), mid-arm muscle circumference (MAMC%), arm muscle area (AMA), the thickness of thumb adductor muscle (APM) and phase angle (PhA°). Data were analyzed by descriptive analysis, t-test and Chi-square. One hundred and one patients were evaluated from March to December 2012, among them 38.30% (n = 54) had CD and 61.70% (n = 87) had UC. Among CD patients: 59.26% were women and 55.56% were in clinical remission. According to Montreal classification 55.56% were A2, 40.74% A3 and 3.70% A1. According to the location, 44.44% were L1, 44.44% were L3 and 11.11% were L2. According to the behavior, 48.15% B2, 27.78% B3, and 24.07% B1; and 40.74% had perianal disease. The BMI showed 11.11% underweight, 48.15% eutrophic and 40.74% overweight or obese. Among UC patients: 55.17% were women and 75.86% were in clinical remission. In accordance with the extent of disease, 45.98% had pancolitis, 31.03% distal colitis and 22.99% left colitis. The BMI distribution showed 6.90% underweight, 40.23% eutrophic, 52.87% overweight or obese. The comparative analysis among patients with UC and DC pointed out a higher percentage of patients with CD in clinical activity (P = 0.01). Anthropometry and body composition assessments showed statistically significant difference in MAMA DC: 35.11(±11.99) x UC:40.39(±16.20) (P = 0.04) and PhA DC:6.46(±0.76) x UC:6.83(±0.80) (P =0.006). There were no difference in other parameters evaluated (Table 1). Among CD patients, those in disease activity had lower values of mean age (P = 0.008), higher percentage of underweight (P = 0.03) and lower values of MAC (P = 0.001), MAMC% (P = 0.04) and AMP% (P = 0.009) when compared to patients in clinical remission. Among patients with UC, those in disease activity had lower values of mean age (P = 0.01), BMI (P = 0.01), MAC (cm) (P = 0.001), MAMC% (P = 0.01) and AMA (P = 0.02) when compared to patients in clinical remission. Although the literature presents data that indicate malnutrition in patients with IBD, this study found a higher prevalence of overweight and obesity. This result can be explained by the inclusion of patients in remission and in disease activity. CD patients had lower values of MAMC% and PhA when compared with patients with UC, which can be explained by the higher percentage of patients with CD in clinical disease activity at the time of evaluation.