Impaired nutrition status may lead to flares in IBD patients
In outpatients with inflammatory bowel disease (IBD), an impaired nutritional status is linked with the risk of subsequent flares, a recent study reports.
Researchers enrolled 417 IBD patients through the myIBDcoach telemedicine tool, from which they accessed participant-reported disease activity. The risk of impaired nutrition status was evaluated according to scores in the Short Nutritional Assessment Questionnaire (SNAQ) and/or body mass index (BMI). Data collection was performed every 1 to 3 months.
Over the 1-year follow-up, 49 patients experienced a flare after initial remission and were classified as relapsers; the remaining 368 were designated as nonrelapsers. At baseline, 53 participants (12.3 percent) were at risk of impaired nutritional status, satisfying either the SNAQ (n=45) or BMI (n=5) definitions. Three patients met both criteria.
Generalized estimating equations analysis found that being at risk of impaired nutritional status significantly increased the likelihood of the occurrence of a flare within 3 months (odds ratio [OR], 2.61, 95 percent CI, 1.02–6.69; p=0.046). Being female (OR, 2.12, 1.08–4.15; p=0.029) was likewise a risk factor, while active smoking (OR, 0.14, 0.02–0.97; p=0.047) appeared to be protective.
Model inclusion of the use of medication at the time of study enrollment attenuated the effect of impaired nutritional status, which nevertheless remained borderline significant (OR, 2.48, 0.96–6.41; p=0.061).
“An impaired nutritional status may contribute to the development of a flare or worse disease outcome by malnutrition induced changes in the immune system leading to altered [gastrointestinal] hormone secretion, changes in immune cell populations and/or increased intestinal permeability,” researchers explained.