Low Phase Angle (pha) Despite Normal Nutritional Status in Patients with Inflammatory Bowel Disease (IBD) in Clinical Remission

Aim: Few data are available on the nutritional status of patients with quiescent IBD. The aim of this project was to assess nutritional status and body composition in IBD patients in clinical remission and compare results to those of healthy controls. We hypothesized that IBD patients, even when they are in clinical remission, display abnormalities in respect to their nutritional status and body composition. Methods: Nutritional status (recent weight loss, Body Mass Index (BMI), Subjective Global Assessment (SGA), serum albumin) was assessed in 57 IBD patients (37f/20m; 40±11yrs.; 23,1±3,1kg/m²) and 57 healthy controls matched for sex-, age- and BMI (37f/20m; 43±13 yrs.; 23,1±3,0kg/m²). Body composition was analysed by bioelectrical impedance analysis (BIA) with Nutriguard 2000M. All IBD patients were in clinical remission (42 Crohn disease patients, Crohn Disease Activity Index (CDAI) 70±46 and 15 ulcerative colitis patients, Lichtiger Colitis Ulcerosa Aktivity Index (CAI) 2,7±1,6). Results: 88% of IBD patients were well nourished according to SGA, BMI and serum albumin. Lean body mass (LBM) was not different between IBD patients and controls (48,4±9,3kg vs. 49,1±9,6kg). However, we observed significantly lower reactance values (IBD: 61±8,4 ohm vs. controls: 69±10,0 ohm and PhA) values (IBD: 5,7±0,7° vs. controls: 6,9±0,7°, P<0,001). 47% of IBD patients had a PhA below the 10th percentile, 74% had PhA values below the 25th percentile. BCM was also decreased in IBD patients (IBD: 24,3±5,8kg vs. controls: 27,6±6,0kg, P<0,001). Conclusion: Our study shows that IBD patients even in disease remission and with apparently normal overall nutritional status show a loss in BCM and have significant lower reactance and PhA values than healthy controls. Reactance and PhA have been associated with cell integrity and function. Therefore, further studies are needed to investigate if impaired functional status is correlated with oxidative stress, disturbed intestinal barrier, subclinical inflammation or a higher rate of disease relapse.