Impact of Disease Activity on Resting Energy Expenditure and Body Composition in Adult Crohn's Disease

Abstract

There is controversy about nutrition status and calorie needs during phases of active versus inactive adult Crohn's disease (CD). Results have been reported in cross-sectional studies, but longitudinal data are unavailable. Our aim was to explore whether disease activity had an impact on resting energy expenditure (REE) and body composition in adult patients with CD. Adult patients were studied on 2 occasions with active and inactive CD. REE was measured by indirect calorimetry. Body composition was estimated from bioelectrical impedance analysis. Disease activity was measured using the Crohn's Disease Activity Index (CDAI). Regression analyses of REE with CDAI score, C-reactive protein, and erythrocyte sedimentation rate were also performed. Seventy-five patients were included. Patients with active CD had increased REE/body weight compared with patients with inactive disease (28.8 ± 5.4 vs 25.9 ± 4.3 kcal/kg, P < .001). Disease behavior and location, but not sex, had an impact on REE/body weight. Body mass index was lower in active disease than in remission (17.4 ± 3.0 vs 18.1 ± 2.6 kg/m(2), P = .010). Body composition was not affected by disease behavior or location. Patients with remission had a better nutrition status and decreased REE compared with those with active CD. REE could also be affected by disease location and behavior.