Energy expenditure and body composition in children with Crohn’s disease: effect of enteral nutrition and treatment with prednisolone

• Published in: Gut 1997-08, Vol.41 (2), p.203-208
• Main Authors: Azcue, M, Rashid, M, Griffiths, A, Pencharz, P B
• Format: Article
• Language: English
• Subjects: Adolescent; Anorexia; anorexia nervosa; Anorexia Nervosa - metabolism; Anti-Inflammatory Agents - therapeutic use; Biological and medical sciences; Body composition; Body Composition - physiology; Body Height; Combined Modality Therapy; Crohn Disease - drug therapy; Crohn Disease - metabolism; Crohn Disease - therapy; Crohn's disease; Electric Impedance; Energy Metabolism - physiology; Enteral Nutrition; Female; Humans; Inflammatory Bowel Disease; Investigative techniques, diagnostic techniques (general aspects); Male; Malnutrition; Medical sciences; Miscellaneous. Technology; Musculoskeletal system; Nutrition; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Potassium; prednisolone; Prednisolone - therapeutic use; resting energy expenditure; Studies; Teenagers
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.41.2.203

Background—Malnutrition and growth retardation are common complications of Crohn’s disease in children. The contribution of resting energy expenditure (REE) to malnutrition is unclear. Aims—To characterise the REE and body composition in children with Crohn’s disease and compare them with normal controls and patients with anorexia nervosa; to compare the effects of prednisolone and enteral nutrition on energy expenditure and body composition. Subjects—Twenty four children with Crohn’s disease, 19 malnourished females with anorexia nervosa, and 22 healthy control subjects were studied. Methods—In children with Crohn’s disease measurements were done when the disease was acute and repeated at one and three months after treatment with either prednisolone or enteral nutrition. Resting energy expenditure was measured by indirect calorimetry and body composition by anthropometry, bioelectrical impedance analysis, total body potassium, H2 18O, and bromide space studies. Results—Body weight and ideal body weight were significantly lower in patients with Crohn’s disease than in healthy controls. Lean tissue was depleted and there was an increase in extracellular water. Per unit of lean body mass, there was no difference between REE in patients with Crohn’s disease and controls, whereas patients with anorexia nervosa had significantly reduced REE. With enteral nutrition all body compartments and REE increased significantly (p