scholarly journals Bone turnover and nutritional status in Crohn's disease: relationship to circulating mononuclear cell function and response to fish oil and antioxidants

2005 ◽  
Vol 64 (2) ◽  
pp. 183-191 ◽  
Author(s):  
T. M. Trebble
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Bone Turnover ◽  
Fish Oil ◽  
Body Mass ◽  
Adult Patients ◽  
Inflammatory Activity ◽  
Epa And Dha ◽  
Ifn Γ

Crohn's disease is associated with osteoporosis, malnutrition and altered function of peripheral blood mononuclear cells (PBMC). The responses of circulating immune cells and extra-intestinal manifestations to increased inflammatory activity and to modulation by dietary supplementation are uncertain. The relationships between disease status, bone turnover and body mass and composition, PBMC function and fatty acid availability have been investigated in patients with Crohn's disease. The availability of n-3 and n-6 PUFA is altered in adult patients and interferon (IFN)-γ production by PBMC is lower. Increased inflammatory activity is associated with increased bone resorption in adult patients and decreased body mass in paediatric patients. In healthy male subjects there is a proportionate relationship between supplementary intake of EPA and DHA (0.3–2.0 g as fish oil/d) in combination with antioxidants (vitamins A, C and E and Se) and incorporation into plasma phospholipids and PBMC, and a non-linear relationship with PBMC synthesis of TNF-α, IL-6 and prostaglandin E2 (decrease) and IFN-γ (increase). In adults with Crohn's disease high-dose fish oil (2.7 g EPA+DHA/d) in combination with antioxidants (vitamins A, C and E and Se) increases the EPA and DHA content of PBMC and decreases the production of IFN-γ by PBMC, but is not associated with effects on bone turnover or nutritional status.

High-dose fish oil and antioxidants in Crohn's disease and the response of bone turnover: a randomised controlled trial

2005 ◽  
Vol 94 (2) ◽  
pp. 253-261 ◽  
Author(s):  
Timothy M. Trebble ◽  
Mike A. Stroud ◽  
Stephen A. Wootton ◽  
Philip C. Calder ◽  
David R. Fine ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Randomised Controlled Trial ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Bone Turnover ◽  
Fish Oil ◽  
Controlled Trial ◽  
Interferon Γ ◽  
High Dose ◽  
Randomised Controlled

Crohn's disease is associated with altered bone turnover that may be influenced by nutritional status, the systemic inflammatory response, cytokine production by circulating (peripheral blood) mononuclear cells (PBMC) and antioxidant micronutrient intake. High-dose fish oil is associated with reductions in disease relapse and inflammatory markers, and modulates PBMC function. The effect of fish oil plus antioxidants on bone turnover and PBMC function (the production of interferon-γ and prostaglandin E2) in Crohn's disease was investigated in a randomised-controlled trial. Patients with currently or recently raised biochemical markers of inflammation (C-reactive protein ≧6·9 mg/l or erythrocyte sedimentation rate ≧18 mm/h) received fish oil (providing 2·7 g/d EPA and DHA) and antioxidants (vitamins A, C and E, and Se) (n 31) or placebo (n 30) for 24 weeks. Bone turnover was assessed by measuring the concentrations of urinary deoxypyridinoline (bone resorption) and serum osteocalcin (bone formation). Fish oil plus antioxidants were associated with increases in EPA, DHA Se in plasma (all P<0·01), and with a reduction in interferon-γ production by mitogen-stimulated PBMC, which demonstrated a negative correlation with deoxypyridinoline/creatinine:osteocalcin ratio (r −0·33, P=0·009). There were no differences between the groups at 24 weeks in the response of deoxypyridinoline or osteocalcin or their ratio, or in nutritional status. Dietary supplementation in Crohn's disease with high intakes of EPA and DHA, as fish oil, plus antioxidants was associated with a modulated production of interferon-γ by PBMC but not altered indices of bone turnover.

scholarly journals Association between Health-Related Quality of Life and Nutritional Status in Adult Patients with Crohn’s Disease

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 746 ◽  
Author(s):  
Iolanda Cioffi ◽  
Nicola Imperatore ◽  
Olivia Di Vincenzo ◽  
Lidia Santarpia ◽  
Antonio Rispo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Gender Differences ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Adult Patients ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

This study aimed to assess health related quality of life (HRQoL) in adult patients with Crohn’s disease (CD), considering disease severity and gender differences, and also its relationship with nutritional status. Consecutive adult patients aged 18–65 years with CD were recruited. Disease activity was clinically defined by the Crohn’s Disease Activity Index (CDAI) in active and quiescent phases. HRQoL was evaluated using the validated short form (SF)-36 questionnaire for the Italian population. Additionally, anthropometry, bioimpedance analysis, and handgrip-strength (HGS) were performed. Findings showed that 135 patients (79 men and 56 women) were included, having a mean age of 38.8 ± 14 years and a BMI of 23.2 ± 3.7 kg/m2. Overall, active CD patients had a lower perception of their QoL compared to those clinically quiescent, while gender differences emerged mostly in the quiescent group. Interestingly, HRQoL was significantly associated with many nutritional variables, and muscle strength was the main predictor. Therefore, HRQoL is perceived lower in active compared to quiescent patients, but women experienced poorer QoL than men, especially in the quiescent phase. Finally, higher QoL scores were found in subjects being in clinical remission phase with a preserved muscle function. However, further studies are still required to verify these findings.

scholarly journals Handgrip Strength Index Predicts Nutritional Status as a Complement to Body Mass Index in Crohn’s Disease

2016 ◽  
Vol 10 (12) ◽  
pp. 1395-1400 ◽  
Author(s):  
Ze Lan Lu ◽  
Tian Rong Wang ◽  
Yu Qi Qiao ◽  
Qing Zheng ◽  
Ying Sun ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Nutritional Status ◽  
Body Mass ◽  
Handgrip Strength ◽  
Strength Index

scholarly journals Effect of phylloquinone (vitamin K1) supplementation for 12 months on the indices of vitamin K status and bone health in adult patients with Crohn's disease

2014 ◽  
Vol 112 (7) ◽  
pp. 1163-1174 ◽  
Author(s):  
Eibhlís M. O'Connor ◽  
Geraldine Grealy ◽  
Jane McCarthy ◽  
Alan Desmond ◽  
Orla Craig ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bone Mass ◽  
Bone Turnover ◽  
Vitamin K ◽  
Bone Health ◽  
Adult Patients ◽  
Undercarboxylated Osteocalcin ◽  
Double Blind

Although epidemiological findings support a role for vitamin K status in the improvement of bone indices in adult patients with Crohn's disease (CD), this needs to be confirmed in double-blind, randomised controlled trials (RCT) with phylloquinone (vitamin K1). By conducting two RCT, the present study aimed to first establish whether supplementation with 1000 μg of phylloquinone daily near-maximally suppresses the percentage of undercarboxylated osteocalcin in serum (%ucOC; marker of vitamin K status) in adult patients with CD currently in remission as it does in healthy adults and second determine the effect of supplementation with phylloquinone at this dose for 12 months on the indices of bone turnover and bone mass. The initial dose-ranging RCT was conducted in adult patients with CD (n 10 per group) using 0 (placebo), 1000 or 2000 μg of phylloquinone daily for 2 weeks. In the main RCT, the effect of placebo v. 1000 μg vitamin K/d (both co-administered with Ca (500 mg/d) and vitamin D3 (10 μg/d)) for 12 months (n 43 per group) on the biochemical indices of bone turnover (determined by enzyme immunoassay) and bone mass (determined by dual-energy X-ray absorptiometry) were investigated. At baseline, the mean %ucOC was 47 %, and this was suppressed upon supplementation with 1000 μg of phylloquinone daily ( − 81 %; P< 0·01) and not suppressed further by 2000 μg of phylloquinone daily. Compared with the placebo, supplementation with 1000 μg of phylloquinone daily for 12 months had no significant effect (P>0·1) on bone turnover markers or on the bone mass of the lumbar spine or femur, but modestly increased (P< 0·05) the bone mass of the total radius. Despite near maximal suppression of serum %ucOC, supplementation with 1000 μg of phylloquinone daily (with Ca and vitamin D3) had no effect on the indices of bone health in adult CD patients with likely vitamin K insufficiency.

Sign in / Sign up

Export Citation Format

Share Document