Ist Department of Paediatrics, Semmelweis University, Budapest, Hungary
Introduction: Patients with inflammatory bowel disease (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC) may have a higher risk for infections due to underlying disease, malnutrition or immunosuppressive therapy. The fat free mass (FFMI) shows the metabolically active part of the body, and therefore it seems to be a better marker for estimating the nutritional status.
Aims: The aim of our study was to investigate the responsiveness of hepatitis B vaccinations depending on the patients nutritional status. According to our knowledge there is no other study analysing FFMI to specify the nutritional status by estimating the level of malnutrition
Method: Weight, Body Mass Index (BMI) and FFMI values were investigated to estimate the nutritional status of our patients. FFM was measured using bioimpedance. Patients FFMI values were compared with age and sex paired controls (C). To check the response to the previously administered hepatitis B vaccine anti-HBs titers were determined. A level >100 IU/l was accept as seroprotective.
Results: Our study involved 25 IBD patients (CD: 16, male: 14, mean age: 14.72, range: 12.11-18.78). Only 8 patients had a seroprotective anti-HBs titers (responder group, R, n=8). 13 patients did not have a seroprotective anti-Hbs titer (non-responder group NR, n=13) following immunisation. However, weight (R: -0,71; NR: -1,13), and BMI (R: -0.99, NR: -1,24) z-scores were in normal range. In addition, FFMI was lower in both R and NR group compared to C (R vs. C: p<0.005, NR vs. C: p<0.0005). Related to nutritional status, there was no difference between the R and NR group.
Conclusion: Interestingly, in our study the nutritional status was not a significant factor in the anti-Hbs seroprotection level. It seems that immunosuppression in paediatric IBD patients did not have a significant effect on malnutrition status.
Doctoral School: Clinical Medicine
Program: Prevention of Chronic Diseases in Childhood
Supervisor: Gábor Veres