P428 Nutritional, Muscular status and micronutrient deficiencies in patients with Inflammatory Bowel Disease

Abstract

Abstract Background Malnutrition and micronutrient deficiencies are common in inflammatory bowel disease (IBD). Nutrient deficiencies increase the morbidity and complications of IBD. The aim of this study was to evaluate the nutritional and muscular status and identify micronutrient deficiencies of patients with IBD receiving treatment. Methods A total of 105 patients with IBD were enrolled prospectively in the department of gastroenterology and pediatrics from June 2019 to October 2021. To obtain objective data, iron, ferritin, phosphate, folate, Mg, 25-OH vitamin D, vitamin B12, and Zinc were measured in the patient's serum. In addition, body composition analysis was performed using bioelectrical impedance analysis to gain information regarding muscular status. Results There were 51 patients with ulcerative colitis (UC), 54 with Crohn's disease (CD), and the gender ratio (M:F) was 54:51. The average age was 37±18 years, which was significantly lower in patients with CD than UC (28.6±15.9 vs. 45.3±16.3, p<0.001). The mean body mass index (BMI) was 22.0 ± 3.7 kg/m2, lower in patients with CD than UC (21.2 ± 3.8 kg/m2, vs. 22.0 ± 3.3 kg/m2, p=0.030). The disease activity of the patients was 64.8% in remission, with 17.1% mild, 15.2% moderate, and 2.9% severe. In the UC and CD patient groups, skeletal muscle index(SMI) and adjusted skeletal muscle mass were lower in patients with CD compared to UC.(SMI : 35.8±5.5 vs. 32.8±4.7 %, p<0.004, adjusted skeletal muscle : 8.2±1.9 vs. 7.0±1.5 kg/m2, p<0.001) However, there was no difference of SMI and adjusted skeletal muscle according to disease activity in both UC and CD patients (Table 1). Iron was lower in patients with CD compared to UC (63.3 ± 42.5 vs. 82.8 ± 44.0 ug/dL, p=0.024). Ferritin, phosphorus, folic acid, vitamin B12, and zinc were also within normal limits. Magnesium was lower in patients with CD compared to UC (2.08 ± 0.15 vs. 2.15 ± 0.19, p=0.036 mg/dL). Vitamin D levels showed insufficient vitamin D in patients with UC and vitamin D deficiency (below 20 ng/mL) in patients with CD (20.1 ± 10.6 vs. 19.0 ± 9.9 ng/mL, p = 0.567) (Table 2). Conclusion Nutritional status of patients with IBD is favorable, and the lack of trace elements, specifically iron, magnesium, and vitamin D, and reduced skeletal muscle mass were observed to be prominent in patients with CD compared to UC.