The Impact Of EN Support On Body Composition And Energy Metabolism In CD Patients

Background:A number of studies have showed that the body composition and metabolism of CD patients have a close relationship with disease activity, however the exact relationship between them hasn’t been defined. Enteral nutritional therapy (EN) is an effective modality for inducing and maintaining remission in patients with CD. What’s the impact of EN on the body composition and metabolism of CD patients?Objective:This study aims to find the difference of body composition and REE between active and remission phase, to make it clear that whether EN has influence on the body composition and REE or not, and also to compare measured REE with predicted REE.Methods:Thirty-one patients with proven CD were enrolled in the study, they have received total enteral nutrition (TEN) support (nutrison fibre) as the only treatment for 4 weeks. The information of body composition such as weight, body mass index (BMI), skeletal muscle mass (SMM), fat mass, protein mass and the inflammation index such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and Crohn’s disease activity index (CDAI) were recorded before and after EN support. Statistical method was used to analyze the data. Thirty-one patients were divided into three groups, group A (active phase into remission via EN,N=11), group B(still in the active phase via EN,N=9), group C(in remission before and after EN, N=11).Results:Patients in group A had a significant increase in BMI, SMM and protein mass(p<0.05) and decreased REE per kg of weight while others in group B and C had no important difference in body composition and REE(p>0.05).Patients in group A had no difference between predicted and measured REE by Harris-Benedict formula.Conclusions:EN can induce clinical remission and improve the body composition of CD patients at the same time, such as BMI,SMM and protein mass.The same patient had a much higher REE in active phase than in remission. EN can correct the hypermetabolism by controlling the inflammation. Harris-Benedict formula can be used to predict REE of CD patients in active phase.