Ernæringsstatus hos voksne pasienter med inflammatorisk tarmsykdom som får biologisk behandling ved Sørlandet sykehus

Rationale: Patients with inflammatory bowel disease (IBD) belong to a high-risk group for malnutrition [1]. The aim was to evaluate if «Nutritional Risk Screening 2002» (NRS 2002) detects patients at nutritional risk, and if patients who are not at risk may have deficiencies or changed body composition. Methods: This was a cross-sectional study including 60 consecutive IBD outpatients who were currently treated with biologic drugs. All patients were screened by NRS 2002 and by biochemical testing for nutritional deficiencies. 30 patients (focus group) were randomly selected for evaluation of nutritional intake derived from interview, and for measuring bone mineral density and body composition by Dual X-ray Absorptiometry (DXA). Statistical analyses were performed by the statistical program STATA (version 14.2, produced by StataCorp, USA). Descriptive statistics were used. Results: 33 Crohn’s disease and 27 ulcerative colitis, 35 men and 25 women, aged 18-73 years were included. Only one (2%) patient was at nutritional risk by NRS 2002. 31 (52%) patients had at least one deficiency detected by blood testing defined as homocysteine (>15 µmol/L), MMA (≥0,3 µmol/L), folic acid (≤6 nmol/L), 25-OH-vitamin D (<50 nmol/L) and/or transferrin-receptor (<menn 2,2 og kvinner <1,9) mg/L) outside the reference areas. In the focus group, many patients had lower intake of fibre (60%), folate (67%), iron (60%), vitamin D (67%) and calcium (47%) than recommended by Norwegian dietary guidelines. Low bone mineral density (T-score ≤ -1) was found in 17 (57%) patients (focus group). Overweight or obesity was detected in 23 (77%) patients based on body fat mass index (BFMI). 5 (42%) patients with normal body mass index (BMI) (18,6-24,9 kg/m2 ) had overweight based on BFMI. Malnutrition was detected in 5 (17%) patients by fat-free mass index (FFMI) (men ≤16,6 kg/m2 , women ≤14,5 kg/m2 ), but none of these had weight loss or BMI