Intest Res.  2022 Jul;20(3):321-328. 10.5217/ir.2021.00022.

Evaluation of nutritional status using bioelectrical impedance analysis in patients with inflammatory bowel disease

• Kim SH
• Kim YS
• Lee SH
• Lee HM
• Yoon WE
• Kim SH
• Myung HJ
• Moon JS

• KMID: 2531986
• DOI: http://doi.org/10.5217/ir.2021.00022

Abstract

Background/Aims
Nutritional status influences quality of life among patients with inflammatory bowel disease (IBD), although there is no clear method to evaluate nutritional status in this setting. Therefore, this study examined whether bioelectrical impedance analysis (BIA) could be used to evaluate the nutritional status of patients with IBD.
Methods
We retrospectively analyzed data from 139 Korean patients with IBD who were treated between November 2018 and November 2019. Patients were categorized as having active or inactive IBD based on the Harvey-Bradshaw index (a score of ≥5 indicates active Crohn’s disease) and the partial Mayo scoring index (a score of ≥2 indicates active ulcerative colitis). BIA results and serum nutritional markers were analyzed according to disease activity.
Results
The mean patient age was 45.11±17.71 years. The study included 47 patients with ulcerative colitis and 92 patients with Crohn’s disease. Relative to the group with active disease (n=72), the group with inactive disease (n=67) had significantly higher values for hemoglobin (P<0.001), total protein (P<0.001), and albumin (P<0.001). Furthermore, the group with inactive disease had higher BIA values for body moisture (P=0.047), muscle mass (P=0.046), skeletal muscle mass (P=0.042), body mass index (P=0.027), and mineral content (P=0.034). Moreover, the serum nutritional markers were positively correlated with the BIA results.
Conclusions
Nutritional markers evaluated using BIA were correlated with serum nutritional markers and inversely correlated with disease activity. Therefore, we suggest that BIA may be a useful tool that can help existing nutritional tests monitor the nutritional status of IBD patients.

Keyword

Inflammatory bowel diseases; Crohn disease; Colitis, ulcerative; Bioelectrical impedance analysis; Nutritional assessment

Figure

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  Fig. 1. Flowchart of the selection process for research subjects among inflammatory bowel disease patients. CKD, chronic kidney disease; HF, heart failure; UC, ulcerative colitis; CD, Crohn’s disease.

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  Fig. 2. The level of hemoglobin showed good correlation with the nutritional factors of bioelectrical impedance analysis. (A) Correlation between hemoglobin and body moisture (r=0.396; 95% CI, 0.258–0.527; P<0.001). (B) Correlation between hemoglobin and muscle mass (r=0.400; 95% CI, 0.262–0.530; P<0.001). (C) Correlation between hemoglobin and skeletal muscle mass (r=0.412; 95% CI, 0.277–0.539; P<0.001). (D) Correlation between hemoglobin and mineral (r=0.319; 95% CI, 0.187–0.348; P<0.001). r, Pearson correlation coefficient; CI, confidence interval. Statistically significant, P<0.05.

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  Fig. 3. The level of total protein showed good correlation with the nutritional factors of bioelectrical impedance analysis. (A) Correlation between total protein and body moisture (r=0.265; 95% CI, 0.127–0.403; P=0.002). (B) Correlation between total protein and muscle mass (r=0.268; 95% CI, 0.130–0.404; P=0.002). (C) Correlation between total protein and skeletal muscle mass (r=0.274; 95% CI, 0.138–0.406; P=0.001). (D) Correlation between total protein and mineral (r=0.214; 95% CI, 0.081–0.348; P=0.013). r, Pearson correlation coefficient; CI, confidence interval. Statistically significant, P<0.05.

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  Fig. 4. The level of albumin showed good correlation with the nutritional factors of bioelectrical impedance analysis. (A) Correlation between albumin and body moisture (r=0.226; 95% CI, 0.075–0.368; P=0.008). (B) Correlation between albumin and muscle mass (r=0.230; 95% CI, 0.077–0.370; P=0.007). (C) Correlation between albumin and skeletal muscle mass (r=0.242; 95% CI, 0.088–0.382; P=0.005). (D) Correlation between albumin and mineral (r=0.185; 95% CI, 0.048–0.321, P=0.031). r, Pearson correlation coefficient; CI, confidence interval. Statistically significant, P<0.05.

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