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


OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Burnham
Jon M
JM
Department of Pediatrics, Division of Rheumatology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. burnhams@email.chop.edu
Shults
Justine
J
Semeao
Edisio
E
Foster
Bethany J
BJ
Zemel
Babette S
BS
Stallings
Virginia A
VA
Leonard
Mary B
MB
D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D001823:Body Composition; D002100:Cachexia / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000378:metabolism*; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male