title: Systematic review: body composition in adults with inflammatory bowel disease.
abstract: BACKGROUND
  There is a paucity of data on body composition in patients with inflammatory bowel disease (IBD). Alterations of fat and muscle may affect bone health, muscle performance, quality of life (QoL) and overall morbidity.
  
  
  OBJECTIVE
  To systematically review the literature on body composition in adults with IBD, and to discuss potential contributory factors and associations.
  
  
  METHODS
  A systematic search was performed in July 2012 of OVID SP MEDLINE, OVID EMBASE and National Library of Medicine's PubMed Central Medline (Limitations: English, humans, from 1992). A total of 19 articles comparing body composition in patients with IBD with healthy age- and sex-matched control populations were included in the primary analysis.
  
  
  RESULTS
  A total of 631 patients with Crohn's disease (CD) and 295 with ulcerative colitis (UC), mean age 37.1 (s.d. ± 9.2) years; 485 (52%) female, were reported upon. Data were heterogeneous and methodology varied. Compared with controls, a statistically significant reduction in body mass index (BMI) was reported in 37% of CD and 20% of UC patients; reduced fat-free mass in 28% CD and 13% UC patients, and reduced fat mass in 31% CD and 13% UC patients. There was no consistent association between body composition and disease activity, duration, extent or therapies. BMI did not accurately predict body composition.
  
  
  CONCLUSIONS
  Current data, although heterogeneous, suggest that many patients with IBD are affected by aberrations in fat and lean mass, which may not be detected during routine clinical assessment. The prevalence and impact of altered body composition amongst this population warrant further investigation.
authors.affiliation: IBD Service & Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, Australia. robvbryant@gmail.com
authors.forename: R V
authors.initials: RV
authors.lastname: Bryant
authors.forename: M J
authors.initials: MJ
authors.lastname: Trott
authors.forename: F D
authors.initials: FD
authors.lastname: Bartholomeusz
authors.forename: J M
authors.initials: JM
authors.lastname: Andrews
mesh_terms: D000328:Adult; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D011788:Quality of Life