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. 2023 Mar 1;29(3):423-429.
doi: 10.1093/ibd/izac102.

High Prevalence of Malnutrition and Micronutrient Deficiencies in Patients With Inflammatory Bowel Disease Early in Disease Course

Stephanie L Gold  1 , Loren G Rabinowitz  2 , Laura Manning  3 , Laurie Keefer  3 , William Rivera-Carrero  3 , Stephanie Stanley  4 , Alexis Sherman  3 , Ana Castillo  3 , Stacy Tse  3 , Amanda Hyne  3 , Kristina Matos  3 , Benjamin Cohen  5 , Ari Grinspan  1 , Jean-Frederic Colombel  1 , Bruce E Sands  1   3 , Marla C Dubinsky  1   6 , Ryan C Ungaro  1
Affiliations

High Prevalence of Malnutrition and Micronutrient Deficiencies in Patients With Inflammatory Bowel Disease Early in Disease Course

Stephanie L Gold et al. Inflamm Bowel Dis. .

Abstract

Background: Patients with inflammatory bowel disease (IBD) are at an increased risk of malnutrition. The goal of this study was to define the prevalence of malnutrition and micronutrient deficiencies in recently diagnosed IBD patients and to compare the performance of existing malnutrition screening tools in identifying IBD patients at increased risk for malnutrition.

Methods: This was a retrospective cohort study of adult patients with recently diagnosed IBD (≤18 months disease duration). A diagnosis of malnutrition was made utilizing the European Society for Clinical Nutrition and Metabolism malnutrition criteria. Serum micronutrient levels were included. The sensitivity of 5 malnutrition screening tools in identifying patients at moderate-high risk of malnutrition was determined based on the European Society for Clinical Nutrition and Metabolism malnutrition definition. Descriptive statistics summarized the data and univariate analyses tested associations.

Results: A total of 182 patients were included for analysis; 65 (36%) met criteria for malnutrition. A total of 135 (74%) patients had ≥1 micronutrient level checked and 105 (78%) had ≥1 deficiency. Patients with prior surgery (odds ratio [OR], 4.5; P = .004), active Crohn's disease (OR, 2.8; P = .03), and diarrhea (OR, 2.1; P = .02) were more likely to be malnourished. The Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool had the highest sensitivity (100%) in predicting those at moderate-high risk of malnutrition at the time of screening.

Conclusions: Patients with recently diagnosed IBD have a high prevalence of malnutrition and micronutrient deficiencies. Both the Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool can be used to identify those at increased risk of malnutrition. Future studies and screening tool development are necessary to identify those at risk of developing malnutrition to facilitate timely referral for nutritional evaluation and prevent disease related complications.

Keywords: Inflammatory bowel disease; Malnutrition; Micronutrient Deficiencies; Screening.

Plain language summary

This retrospective cohort study identified that patients with recently diagnosed inflammatory bowel disease have a high prevalence of malnutrition as well as micronutrient deficiencies and compared the utility of 5 available malnutrition screening tools in this population.

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Figures

Figure 1.
Figure 1.
Retrospective cohort study design and the development of malnutrition over 6 and 12 months. Figure created with BioRender.com.
Figure 2.
Figure 2.
Percentage of patients identified as high-risk for malnutrition by the 5 screening tools utilized in this study. Figure created with BioRender.com. MIRT, Malnutrition Inflammatory Risk Tool; MUST, Malnutrition Universal Screening Tool; NRI, Nutritional Risk Index; SaskIBD-NR, Saskatchewan Inflammatory Bowel Disease, Nutrition Risk Tool; SNAQ, Short Nutrition Assessment Questionnaire.
Figure 3.
Figure 3.
Number of patients with serum micronutrient levels checked and deficiencies identified. Figure created with BioRender.com. Vit., vitamin.
See this image and copyright information in PMC

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