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Observational Study
. 2023 Mar;77(3):380-385.
doi: 10.1038/s41430-022-01245-9. Epub 2022 Dec 7.

Body composition, physical activity, and quality of life in pediatric patients with inflammatory bowel disease on anti-TNF therapy-an observational follow-up study

Kriszta Katinka Boros  1 , Gábor Veres  2 , Orsolya Cseprekál  3 , Hajnalka Krisztina Pintér  4 , Éva Richter  1 , Áron Cseh  1 , Antal Dezsőfi-Gottl  1 , András Arató  1 , György Reusz  1 , Dóra Dohos  5   6 , Katalin Eszter Müller  7   8
Affiliations
Observational Study

Body composition, physical activity, and quality of life in pediatric patients with inflammatory bowel disease on anti-TNF therapy-an observational follow-up study

Kriszta Katinka Boros et al. Eur J Clin Nutr. 2023 Mar.

Abstract

Background: Poor outcome of inflammatory bowel disease (IBD) is associated with malnutrition. Our aim was to compare body composition (BC) and physical activity (PA) between patients with IBD and healthy controls, and to assess the changes in BC, PA and health related quality of life (HRQoL) in children with IBD during anti-TNF therapy.

Methods: 32 children with IBD (21 with Crohn's disease (CD), (age: 15.2 ± 2.6 years, 9 male) and 11 with ulcerative colitis (UC), (age: 16.4 ± 2.2 years, 5 male) participated in this prospective, observational follow up study conducted at Semmelweis University, Hungary. As control population, 307 children (age: 14.3 ± 2.1) (mean ± SD) were included. We assessed BC via bioelectric impedance, PA and HRQoL by questionnaires at initiation of anti-TNF therapy, and at two and six months later. The general linear model and Friedman test were applied to track changes in each variable.

Results: During follow-up, the fat-free mass Z score of children with CD increased significantly (-0.3 vs 0.1, p = 0.04), while the BC of patients with UC did not change. PA of CD patients was lower at baseline compared to healthy controls (1.1 vs. 2.4), but by the end of the follow up the difference disappeared.

Conclusions: The fat-free mass as well as PA of CD patients increased during the first six months of anti-TNF treatment. As malnutrition and inactivity affects children with IBD during an important physical and mental developmental period, encouraging them to engage in more physical activity, and monitoring nutritional status should be an important goal in patient care.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Fat free mass Z score changes in patients.
A CD Crohn’s disease, M0 measurement 0, M2 measurement 2, M6 measurement 6, *: vs. M0, p < 0.05. B UC ulcerative colitis, M0 measurement 0, M2 measurement 2, M6 measurement 6.
Fig. 2
Fig. 2. Physical activity of patients compared to age, sex and BMI Z score adjusted controls.
A PAQ Physical activity questionnaire, M0 Measurement 0, M2 measurement 2, M6 measurement 6; ****: vs. Controls, p < 0.00005. B PAQ Physical activity questionnaire, M0 Measurement 0, M2 measurement 2, M6 measurement 6.
Fig. 3
Fig. 3. Changes of skeletal muscle mass Z score in children with or without risk of sarcopenia during the study period.
SMM skeletal muscle mass, M0 measurement 0, M2 measurement 2, M6 measurement 6; *: vs. M0, p < 0.05; **:vs. M0, p < 0.005; ###: vs. the equivalent parameter in SMM Z score < -1, p < 0.0005.
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