Altered subjective appetite parameters in Crohn's disease patients

Background and Aim: Altered appetite and early satiety may promote anorexia associated with Crohn's disease. The aim of this study was to assess the i mpact of disease activity on subjective appetite parameters in Crohn's dise ase patients. Methods: Seventeen patients with Crohn's disease and 15 healt hy controls (8 M: 7 F, 34 (20-35) years) were studied. Subjects rated their hunger, desire to eat, fullness and level of satiety using visual analogue scales after an overnight fast. Subjects were reassessed after ingestion o f 500 and 1000 ml water. Anthropometry was used to determine percentage bod y fat. Serum leptin & TNF-a levels were assessed using immunoassay. Disease activity was determined using the Harvey-Bradshaw index. Results: Hunger r atings for active Crohn's disease patients were significantly lower than co ntrols at baseline (P < 0.05). Desire to eat was lower in patients with act ive Crohn's disease than controls both at baseline (95% Cl, 0.3 mm, 40.7 mm ) and after ingestion of 500 ml water (95% Cl, 1.25 mm, 51.9 mm) (P < 0.05) . Serum leptin concentrations were significantly associated with percent bo dy fat (r = 0.57; P < 0.001) and, after correcting for body fat status, ten ded to be higher in patients with active Crohn's disease (mean 0.9 ng/ml/% body fat; SD 0.8 ng/ml/% body fat) compared with either patients with inact ive disease (mean 0.4 ng/ml/% body fat; SD 0.3 ng/ml/% body fat) or healthy controls (mean 0.3 ng/ml/% body fat; SD 0.2 ng/ml/% body fat) (P = 0.15, n s). Appetite parameters and serum leptin concentrations showed no significa nt correlation. Conclusions: Subjective appetite parameters were altered in patients with active Crohn's disease. At baseline, patients with active Cr ohn's disease were less hungry than healthy controls and had less desire to eat. After ingestion of 500 ml of water, desire to eat was significantly l ess in patients with active disease as compared with healthy controls. Seru m leptin concentration corrected for percent body fat tended to be higher i n patients with active Crohn's disease compared with inactive Crohn's disea se and healthy controls, but the differences did not reach statistical sign ificance. (C) 2001 Harcourt Publishers Ltd.