METABOLIC FEATURES OF INFLAMMATORY BOWEL-DISEASE IN A REMISSION PHASEOF THE DISEASE-ACTIVITY

Objectives. To evaluate the anthropometric and metabolic characteristi cs of patients with Crohn's disease (CD) and ulcerative colitis (UC), comparing both groups with healthy volunteers. Design. A cross-section al study. Setting. The Department of Internal Medicine, Catholic Unive rsity Hospital, Rome, Italy Subjects. Thirty-four patients with biopsy -proven inflammatory bowel disease (18 CD; 16 UC) in clinical remissio n (SCDAI <3 and Powell-Tuck; index <4) not receiving steroid therapy. Interventions. All patients had a clinical examination. Main outcome m easures. Blood indicators of inflammation and nutritional status. Body composition was assessed by both anthropometry and bioimpedance and m etabolic variables were measured by indirect calorimetry over a 60-90 min period. Results. CD had a lower body weight than both controis (58 .1 kg, range 41.5-71.0 vs. 66.4 kg, range 57.0-76.0; P < 0.001) and UC ) 58.1 kg, range 41.5-71.0 vs. 69.6 kg, range 50.5-94.0; P < 0.001). F at-free mass (FFM) did not differ between the groups, whilst fat mass was significantly lower in CD than in UC (P < 0.05) and controls (P < 0.001). Normalizing the basal metabolic rate by FFM, a higher value wa s found in CD compared with UC (143 kJ kg(-1) d(-1), range 97.5-179 vs . 133 kJ kg(-1) d(-1), range 123-148; P < 0.05) and control subject 14 3 kJ kg(-1) d(-1), range 97.5-179 vs. 134 kJ kg(-1) d(-1), range 122-1 62; P < 0.05). The nonprotein respiratory quotient was significantly l ower in CD compared to UC 0.80, range 0.73-0.84 vs. 0.84, range 0.79-0 .91; P < 0.01) and controls (0.80, range 0.73-0.84 vs. 0.83, range 0.8 1-0.87; P < 0.001), with a consequently higher lipid oxidation rate in CD. Conclusions. CD subjects showed a decreased fat mass and enhanced utilization of lipids compared with UC and controls. These data could be explained by the larger intestinal involvement and considered as a contribution to lipid tissue wasting in CD.