30 GROWTH FAILURE AND BODY COMPOSITION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE

Abstract

Malnutrition and growth failure are complications of inflammatory bowel disease (IBD) in children. Contributing factors to these effects are malabsorption, inadequate food intake, enhanced loss of nutrients, and corticosteroid treatment. Increased resting energy expenditure (REE) may also contribute to the growth retardation. Twenty children with endoscopicaly and histologically proven ulcerative colitis (n=13) or Crohns disease (n = 7) and twenty age and sex matched controls were studied. REE was measured using a metabolic cart with principle of indirect calorimetry (Deltatrac, Datex, Finland), lean body mass (LBM) with bioelectrical impedance analysis (BIA). With Dual energy X-ray absorptiometry (DEXA) (Lunar Rad. Corp., USA) an analysis of bone mineral density (BMD) and of LBM was done. The median age of IBD children was 13,5 years (range 6-18), of controls 14 years (range 6-18). The mean REE in children was increased: 33 ± 1,7 versus 28,9 ± 1,5 Kcal/kg bodyweight (p<0.01). The LBM was significantly increased in children with IBD versus controls: 81,5 ± 1,7 versus 74,7 ± 1,6% of bodyweight. REE in Kcal/kg LBM was not different in children with IBD versus controls: 41,7 ± 2,1 versus 38,8 ± 2,1 Kcal/kg. No difference in REE was found between patients with low (n=14) and high disease activity (n = 6). In five patients (25%) a decreased BMD (>2 SD below mean value) of lumbar spine was found. An inverse relation between 8MD and cumulative prednison dose was found. The LBM values measured with BIA and with DEXA technique correlated very well (R =0.95).

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