Multidimensional nutritional assessment in Crohn’s disease: cross-sectional comparison of active disease and remission

Malnutrition is common in Crohn’s disease (CD), and its assessment requires multiple tools. Comprehensive evaluation of nutritional status in a population with CD, predominantly characterized by metabolic phenotype, was inadequately reported. This study evaluated the nutritional status of CD patients using anthropometric, clinical, and biochemical measures and compared patients with active disease with those in remission. This cross-sectional study included 127 adults with CD: 63 with active disease and 64 in remission. Disease activity was classified using the Crohn’s Disease Activity Index, the Simple Endoscopic Score for Crohn’s Disease, and magnetic resonance enterography. Nutritional assessment included body mass index (BMI), mid-upper arm circumference, calf circumference, triceps skinfold thickness, mid-arm muscle circumference, Mini Nutritional Assessment-Short Form (MNA-SF), and biochemical markers including hemoglobin, serum iron, folate, vitamin B12, albumin, and zinc. Malnutrition was defined using the Global Leadership Initiative on Malnutrition criteria. Overall, 47.2% of participants were malnourished. Malnutrition was significantly more frequent in active disease than in remission (81.0% vs. 14.1%, P <0.001). Patients with active CD had lower anthropometric indices, MNA-SF score, hemoglobin, serum iron, albumin, and zinc (all P <0.001), whereas folate and vitamin B12 did not differ significantly. BMI showed positive correlations with other anthropometric measures and MNA-SF score (r=0.854–0.914, all P <0.001), whereas correlations with biochemical parameters were weaker and disappeared after subgroup stratification. Overall, the findings indicate that malnutrition is highly prevalent in CD, particularly during active disease. Anthropometric measures and MNA-SF were strongly concordant, whereas biochemical markers were less consistent, supporting a multidimensional nutritional assessment approach in CD.