Impact of enteral nutrition on energy metabolism in patients with Crohn’s disease

• Published in: World journal of gastroenterology : WJG Vol. 21; no. 4; pp. 1299 - 1304
• Main Authors: Zhao, Jie, Dong, Jian-Ning, Gong, Jian-Feng, Wang, Hong-Gang, Li, Yi, Zhang, Liang, Zuo, Lu-Gen, Feng, Yun, Gu, Li-Li, Li, Ning, Li, Jie-Shou, Zhu, Wei-Ming
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.01.2015
• Subjects: Adult; Biomarkers - blood; Body Composition; China; composition; Crohn Disease - diagnosis; Crohn Disease - metabolism; Crohn Disease - physiopathology; Crohn Disease - therapy; Crohn’s; disease;Enteral; Energy Metabolism; Enteral Nutrition; Female; Humans; Inflammation Mediators - blood; Male; Middle Aged; nutrition;Body; Prospective Studies; Prospective Study; Time Factors; Treatment Outcome; China; Enteral nutrition; Metabolism; Body composition; Crohn’s disease
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v21.i4.1299

AIM: To investigate the impact of enteral nutrition(EN) on the body composition and metabolism in patientswith Crohn’s disease(CD). METHODS: Sixty-one patients diagnosed with CD were enrolled in this study. They were given only EN(enteral nutritional suspension, TPF, non-elemental diet) support for 4 wk, without any treatment with corticosteroids, immunosuppressive drugs, infliximab or by surgical operation. Body composition statistics such as weight, body mass index, skeletal muscle mass(SMM), fat mass, protein mass and inflammation indexes such as C-reactive protein(CRP), erythrocyte sedimentation rate(ESR) and CD activity index(CDAI) were recorded before and after EN support. RESULTS: The 61 patients were divided into three groups according to CDAI before and after EN support: A(active phase into remission via EN, n = 21), B(remained in active phase before and after EN, n = 19) and C(in remission before and after EN, n = 21). Patients in group A had a significant increase in SMM(22.11 ± 4.77 kg vs 23.23 ± 4.49 kg, P = 0.044), protein mass(8.01 ± 1.57 kg vs 8.44 ± 1.45 kg, P = 0.019) and decrease in resting energy expenditure(REE) per kilogram(27.42 ± 5.01 kcal/kg per day vs 22.62 ± 5.45 kcal/kg per day, P < 0.05). There was no significant difference between predicted and measured REE in active CD patients according to the HarrisBenedict equation. There was no linear correlation between the measured REE and CRP, ESR or CDAI in active CD patients. CONCLUSION: EN could decrease the hypermetabolism in active CD patients by reducing the inflammatory response.