Article

Body-composition alterations consistent with cachexia in children and young adults with Crohn disease.

Department of Pediatrics, Division of Rheumatology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
American Journal of Clinical Nutrition (impact factor: 6.67). 08/2005; 82(2):413-20. pp.413-20
Source: PubMed

ABSTRACT Crohn disease (CD) in children is associated with low body mass index (BMI), poor growth, and delayed maturation; alterations in lean and fat mass, however, are poorly characterized.
The objective was to quantify lean and fat mass in children and young adults with CD and in healthy control subjects, relative to height and pubertal maturation.
This cross-sectional study assessed whole-body lean and fat mass by using dual-energy X-ray absorptiometry in 104 subjects with CD and in 233 healthy control subjects aged 4-25 y. Linear regression was used to determine the effect of CD on body composition and to generate sex-specific SD scores (z scores) for lean and fat mass relative to height.
Subjects with CD had lower height-for-age and BMI-for-age z scores (P < 0.001 for both) than did control subjects. CD was associated with significant deficits in lean mass after adjustment for height, age, race, and Tanner stage (P = 0.003); deficits in fat mass were not observed. The mean (+/-SD) lean mass-for-height and fat mass-for-height z scores in the subjects with CD were -0.61 +/- 0.92 and -0.04 +/- 0.86, respectively. Within the control group, fat mass-for-height was positively correlated with lean mass-for height (r = 0.41, P < 0.0001); this association was absent in the subjects with CD.
Children and young adults with CD had significant deficits in lean mass but preserved fat mass, which is consistent with cachexia. Further research is needed to identify physical activity, nutritional, and antiinflammatory interventions to improve body composition in persons with CD.

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Keywords

233 healthy control subjects
 
4-25 y. Linear regression
 
BMI-for-age z scores
 
control group
 
control subjects
 
Crohn disease
 
dual-energy X-ray absorptiometry
 
fat mass
 
fat mass-for-height
 
fat mass-for-height z scores
 
healthy control subjects
 
lean mass
 
lean mass-for height
 
low body mass index
 
physical activity
 
pubertal maturation
 
sex-specific SD scores
 
whole-body lean
 
young adults
 
z scores