COMPOSIÇÃO CORPORAL E DINAPENIA EM PACIENTES PEDIÁTRICOS PORTADORES DE DOENÇA INFLAMATÓRIA INTESTINAL

Abstract

Introduction: Crohn's disease (CD) and Ulcerative Colitis (UC), which are chronic inflammatory bowel diseases (IBD), can cause nutritional deficiencies and metabolic changes. These alterations can lead to malnutrition, growth deficiency, excess adipose tissue and low muscle mass. In addition, it can cause a reduction in muscle strength, characterized as dynapenia. Objective: to evaluate the anthropometric status, prevalence of dynapenia and associated clinical and nutritional factors in pediatric patients with Inflammatory Bowel Disease in am outpatient care. Method: this is a cross-sectional study, carried out with patients aged 2 to 18 years, of both sexes, treated at a reference clinic in the State of Bahia. The following data were collected: clinical diagnosis, drug therapy, disease activity, serum levels of vitamin D, erythrocyte sedimentation rate, measurement of weight, height, arm circumference, arm muscle area, triceps and subscapular skinfolds, handgrip strength. The sum of skinfolds, arm muscle area and anthropometric indices were calculated. The anthropometric assessment was classified according to age and sex, according to standardized criteria. Dynapenia was assessed by low relative handgrip strength. Data were analyzed by measures of central tendency, Pearson's chi-square test or Fisher's exact test. Results: in article 1, which described the anthropometric status, 82 patients were evaluated, with a mean age of 11.2 (standard deviation = 4.448). For children under 5 years old, the weight/height index identified a state of malnutrition in 30% of the participants and overweight in 20%. In those over 5 years old, the Body Mass Index/Age identified 11.3% with malnutrition and 14.1% with excess weight. The height/age indicator showed that 19.8% of the participants were short. Body composition measurements showed adipose tissue depletion in 26.7% when assessed by AC and in 4.1% by the sum of skinfolds. Low muscle reserve or risk for deficit was found in 50.9% of participants. The second article, which investigated the presence of dynapenia, evaluated 40 patients, with a mean age of 12.39 years (standard deviation = 3.28). Dynapenia was present in 35% of the participants. There was no association between dynapenia and the evaluated clinical variables. However, a higher frequency of dynapenia was found among females (40%), children under 10 years old (37.5%), patients with Crohn's disease (41.2%), those using corticosteroids (33.3% ), overweight (50%), low muscle reserve (39.1%) and deficient vitamin D (38.5%). Conclusion: the results of the present study allowed us to conclude that the nutritional assessment, based on the anthropometric indices and indicators of body composition, identified that pediatric patients with IBD have some degree of impairment of lean mass and adipose tissue, either in deficit or in excess , and tall. In addition, an important frequency of dynapenia and vitamin D deficiency was identified. Proper nutritional assessment, including identification of muscle strength, are of great importance