Glucose metabolism and insulin sensitivity in inactive inflammatory bowel disease

Background: Inflammatory mediator concentration was found to be increased i n active inflammatory bowel disease, and this could be related to an insuli n-resistant state. Moreover, glucocorticoids, which are widely used in the treatment of inflammatory bowel disease, are notoriously related to insulin resistance. Aim: To measure body composition, whole body glucose uptake and oxidation i n Crohn's disease and ulcerative colitis patients with inactive disease, Methods: All patients had clinical, ultrasound and biochemical assessment. Body composition was determined by isotopic dilution technique; basal metab olic rate and substrate oxidation were measured by indirect calorimetry. In sulin sensitivity was assessed by the euglycaemic hyperinsulinaemic clamp. Ten patients with inactive Crohn's disease (five males, aged 31.1 +/- 7.0 y ears) and 10 patients with inactive ulcerative colitis (five males, aged 33 .4 +/- 8.8 years) participated in the study. Forty healthy subjects, matche d for age and height were used as a control group. Results: Crohn's disease patients showed lower BMI (P < 0.001), fat mass (P < 0.05) and respiratory quotient (P < 0.001) values compared to both ulcerative colitis and contro l subjects. No difference in peripheral glucose uptake (mu mol/kg/min) was found between groups (respectively 42.5 +/- 6.78 in Crohn's disease, 40.2 /- 8.00 in ulcerative colitis and 41.4 +/- 10.8 in control subjects). Gluco se storage and oxidation did not differ between groups. Conclusion: Our data showed that inflammatory bowel disease patients in a r emission phase of the disease activity had a whole body glucose uptake and oxidation similar to those of control subjects, probably due to fat-free ma ss preservation and low blood and tissue cytokine concentration.