Phase angle through electrical bioimpedance as a predictor of cellularity in inflammatory bowel disease

Abstract

It is estimated in Western industrialized countries that inflammatory bowel disease (IBD) has a prevalence of 1 for every 200 inhabitants. In the past, the fat mass disproportionate increase in relation to the fat-free mass was considered uncommon in patients with IBD, due to the observation of the disease being more common with weight loss and malnutrition. However, more in-depth investigations demonstrate that the fat/lean mass disproportion stands out both in prevalence in patients with new diagnoses of ulcerative colitis or Crohn's disease as well as a factor of poor prognosis to the natural evolution of the disease or to the therapeutic response. Another important aspect associated with obesity in IBD is the increased risk of drug clearance [including anti-tumor necrosis factor (TNF) and anti-integrin agents], resulting in short half-life and low trough drug concentrations, since the levels of TNF secreted by adipocytes sequester anti-TNF agents, which could result in suboptimal response to biologics. In view of these characteristic aspects of the inflammatory process of IBD, the identification of cellular functioning is necessary, which can be associated with the staging of the underlying disease, biochemical parameters, and body composition, helping as an indicator for a more accurate clinical and nutritional conduct.

Keywords: Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; Phase angle; Cellularity; Bioelectrical impedance

Core Tip: Inflammatory bowel disease (IBD) patients have a severe inflammatory process that negatively reflects their absorption of vitamins and minerals, resulting in poor nutritional status. Even though it has already been described that these patients need a greater supply of calories and proteins, how will we know if the cells of this patient will be able to metabolize and absorb these nutrients to avoid worsening their nutritional status by overfeeding? Having a tool that serves as a guide for cellular functionality and integrity, such as the phase angle through electrical bioimpedance, is of great relevance in the clinical and nutritional management of patients with IBD.