Physical development and body composition of children with Crohn’s disease

Introduction. Children with Crohn’s disease (CD) are at high risk of developing nutritional deficiencies. Assessment of anthropometric parameters alone does not give us enough information to judge about changes in body composition, while the attention to the problem of deficiency of fat-free and skeletal-muscular body mass in chronic pathology, which may serve as risk factors for a more severe course of the disease, is increasing.
Materials and methods. The study included 121 child diagnosed with CD. All children underwent anthropometric measurements, assessment of body composition by bioelectrical impedance analysis and disease activity index according to the PCDAI scale.
Results. Nutritional deficiency was detected in 55% of the examined children. When assessing body composition, a deficiency of the fat-free mass was detected in 46% of the examined children, 39.7% had a deficiency of skeletal muscle mass, while Z-score of fat mass was reduced in only 6.6% of patients. Thus, a relative increase in the fat component of body composition was detected in the examined patients. A statistically significant inverse correlation of the PCDAI disease activity index was observed with fat-free (p < 0.001; rxy = –0.331), skeletal muscle mass (p < 0.001; rxy = –0.359) and phase angle (p < 0.001; rxy = –0.356). No correlation was obtained with fat mass content. The closest correlation with BMI (p < 0.001; rxy = 0.856) and fat-free mass (p < 0.001;
rxy = 0.764) Z-scores was found for the mid-upper arm circumference. In active CD patients fat-free mass, skeletal-muscular mass, active cellular mass, and phase angle were significantly lower than in those in remission.
Conclusion. Assessment of anthropometric indices, in addition to determining height, body weight, and their indices, should necessarily include measurement of the mid-upper arm circumference and skinfold according to the Z-score for age, the study of body composition parameters in children using bioelectrical impedance analysis, which is an easy to perform, non-invasive and reliable method.

children, Crohn’s disease, anthropometric indicators, body composition, nutritional deficiency

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