title: Comparison between handgrip strength, subjective global assessment, anthropometry, and biochemical markers in assessing nutritional status of patients with Crohn's disease in clinical remission.
abstract: BACKGROUND
  Crohn's disease (CD) may lead to protein and calorie malnutrition (PCM) secondary to impaired digestive and absorptive functions of the small intestine and sometimes to the influence of diet taboos. The earlier the PCM is diagnosed, the higher are the odds of reversal. The objective of this study was to compare different methods of nutritional assessment in patients with CD and correlate them with the disease characteristics.
  
  
  METHODS
  The sample comprised 75 patients with CD from the Gastroenterology Service at the Hospital de Clínicas de Porto Alegre; 37 were male, with a mean age of 38.2 years old (SD = 13.3). All patients had been in clinical remission (CDAI <150) for over 3 months. They were not receiving enteral or parenteral nutrition. The nutritional assessment was considered: body mass index (BMI), triceps skin fold (TSF), arm circumference (MAC), arm muscle circumference (MAMC), subjective global assessment (SGA), non-dominating handgrip strength (HGS) and food intake inquiries.
  
  
  RESULTS
  When comparing the different nutritional assessment methods, 26.7% of the patients were malnourished according to the MAC, 29.3% according to the MAMC, 18.7% according to the SGA, 6.7% according to the BMI, 37.3% according to the TSF and 73.3% according to the HGS. No statistically significant associations were found for disease location, its behavior, drugs utilized, ESR, CRP, age of patients and disease time with the nutritional state verified by HGS, TSF, MAMC and SGA.
  
  
  CONCLUSIONS
  The prevalence of malnutrition is significant in patients with CD, even in clinical remission. The BMI should not be used as reference in this population. The HGS detected a high prevalence of nutritional risk in patients with CD in remission. Studies are required that correlate it with more sensitive methods, for the patients' effective nutritional state assessment.
authors.affiliation: Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, sala 2033, Porto Alegre, RS 90430-000, Brazil.
authors.forename: Céres Maltz
authors.initials: CM
authors.lastname: Bin
authors.forename: Cristina
authors.initials: C
authors.lastname: Flores
authors.forename: Mário Reis
authors.initials: MR
authors.lastname: Alvares-da-Silva
authors.forename: Carlos Fernando Magalhães
authors.initials: CF
authors.lastname: Francesconi
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D004032:Diet; D004734:Energy Metabolism; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D015596:Nutrition Assessment; D012074:Remission Induction; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D014168:Transferrin / Q000032:analysis; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D014168:Transferrin; D002097:C-Reactive Protein