Associations between Body Composition, Disease Activity and Quality of Life in Patients with Crohn’s Disease: A Cross-Sectional Study

Abstract

Background & Aims: Patients with Crohn’s disease (CD) treated with tumor necrosis factor-α (TNF-α) inhibitors are heterogeneous and respond differently to treatment. We aimed to investigate if disease activity and quality of life were associated with the individual varying distribution of fat and fat free mass. Methods: A sample of 83 CD patients treated with TNF-α inhibitors were examined in this single center, cross-sectional study. Body composition was measured by bioelectrical impedance analysis (BIA) and muscle function by handgrip strength (HGS). The association to disease activity assessed by Harvey-Bradshaw Index (HBI), Creactive protein (CRP) and quality of life assessed by Short Health Scale (SHS) was investigated. Results: Increased fat mass index (FMI) was significantly associated to higher disease activity assessed by HBI (p < 0.05) and showed a trend toward a higher CRP level in multivariate non-parametric regression analyses (p=0.07). Univariate tests showed a significant positive association between FMI and SHS as well. Fat free mass index (FFMI) and HGS were not associated to disease activity or quality of life in this population. Conclusion: Despite TNF-α inhibitor therapy, one third of the patients in this study experienced active disease. High FMI was significantly associated to increased disease activity and decreased quality of life. No associations were seen between FFMI, HGS and body composition. Larger studies are needed to confirm these results, and to investigate confounders.