Document Detail


Measurement of nutrition status in Crohn's disease patients receiving infliximab therapy.
MedLine Citation:
PMID:  18849561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: There is limited information on the nutrition impact of antitumor necrosis factor-alpha treatment in adult Crohn's disease (CD). This study was performed to examine the effect of a 6-month course of infliximab on enterocyte function, nutrient status, metabolism, and body composition in these patients.
METHODS: Seven CD patients were assessed for disease activity, enterocyte function, and body composition prior to, after 6 weeks, and after 6 months of infliximab treatment. Measurements included (1) disease activity: Inflammatory Bowel Disease Questionnaire, Harvey Bradshaw Index, and C-reactive protein; (2) enterocyte function: folate, homocysteine, vitamin B(12), citrulline, vitamin D, beta-carotene, d-xylose absorption; (3) Prognostic Inflammatory and Nutritional Index (PINI); and (4) body composition and metabolism: body mass index (BMI), fat and lean body mass, resting energy expenditure (RRE), and respiratory quotient.
RESULTS: Most patients had improvement in disease activity with infliximab. PINI decreased in all patients (-3.35, P = .04). Plasma folate concentration significantly increased. There was an increase in BMI, fat mass, and lean body mass. The respiratory quotient increased in most patients. Changes in citrulline level and REE were inconsistent.
CONCLUSIONS: Crohn's disease patients have improvements in an index that measures both inflammation and nutrition (PINI) with infliximab therapy. Increases in plasma folate suggest improvement in enterocyte function and/or increased oral intake. The increase in respiratory quotient suggests decreased lipolysis and the lack of a starvation state. It was unclear whether weight gain was predominantly fat or lean muscle mass. These finding also support the use of PINI in Crohn's patients as an overall marker of inflammation and nutrition, and as a measure of response to infliximab therapy.
Authors:
Dawn Wiese; Bret Lashner; Douglas Seidner
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  23     ISSN:  0884-5336     ISO Abbreviation:  Nutr Clin Pract     Publication Date:    2008 Oct-Nov
Date Detail:
Created Date:  2008-10-13     Completed Date:  2008-11-13     Revised Date:  2013-02-06    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  551-6     Citation Subset:  IM; N    
Affiliation:
Lerner College of Medicine Cleveland Clinic, 9500 Euclid Avenue NA-24, Cleveland, OH 44195, USA. wiesed@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / therapeutic use*
Antibodies, Monoclonal / therapeutic use*
Basal Metabolism / physiology
Body Composition / physiology
Crohn Disease / blood,  drug therapy*,  metabolism
Enterocytes / physiology
Female
Folic Acid / administration & dosage,  blood
Humans
Male
Middle Aged
Nutritional Status*
Oxygen Consumption*
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
1UL1RR024989-01/RR/NCRR NIH HHS; M01RR018390/RR/NCRR NIH HHS; UL1 RR024989/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/infliximab; 59-30-3/Folic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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