Increased Adiposity and Reduced Lean Body Mass in Patients with Short Bowel Syndrome
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ORIGINAL ARTICLE
Increased Adiposity and Reduced Lean Body Mass in Patients with Short Bowel Syndrome Adeeti J. Chiplunker1 · Ling Chen2 · Marc S. Levin1,3 · Brad W. Warner4 · Nicholas O. Davidson1,5 · Deborah C. Rubin1,5,6 Received: 13 May 2019 / Accepted: 24 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Few studies have examined the metabolic consequences of short bowel syndrome (SBS) and its effects on body composition in adults. We hypothesized that body composition of SBS patients is altered compared to a normal age-, race-, and sex-matched population, regardless of parenteral nutrition (PN) dependence. Aim To compare the body composition of adult patients with SBS to age-, sex-, and race-matched healthy controls. Methods Twenty patients with SBS underwent body composition analysis using the GE Lunar iDXA scanner. Patients were age-, sex-, and race-matched to controls from the National Health and Nutrition Examination Survey (1999–2004). Mean differences in body mass index, fat-free mass, fat mass, percent body fat, visceral adipose tissue mass and volume, and bone mineral density were measured. Statistical analysis was performed using SAS 9.4 software. Results Fifty-five percent of subjects had a history of PN use, and 30% were current PN users. Mean percent body fat for SBS patients was 35.1% compared to 30.9% for healthy controls (p = 0.043). Fat-free mass was reduced in SBS (p = 0.007). Patients with reduced bone mass had a trend toward significantly more years of PN exposure compared to those with normal bone mass (p = 0.094), and a trend toward older age (p = 0.075). Conclusions SBS is associated with increased percent body fat and reduced fat-free mass, suggesting that improved dietary and therapeutic interventions are needed to restore normal metabolic indices and avoid risk of metabolic syndrome in SBS patients. Keywords Short bowel syndrome · Body composition · Parenteral nutrition · Intra-abdominal fat · Body mass index
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-019-06032-4) contains supplementary material, which is available to authorized users.
Abbreviations SBS Short bowel syndrome PN Parenteral nutrition 2
Adeeti J. Chiplunker [email protected]
Division of Biostatistics, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8067, St. Louis, MO 63110, USA
3
Ling Chen [email protected]
VA St. Louis Health Care System, 915 N. Grand Blvd, St. Louis, MO 63106, USA
4
Division of Pediatric Surgery, St. Louis Children’s Hospital, One Children’s Place, Suite 6110, St. Louis, MO 63110, USA
5
Department of Developmental Biology, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, USA
6
William B Kountz Professor of Medicine, Division of Gastroenterology, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, USA
* Deborah C. Rubin [email protected]
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