Impact of short-peptide exclusive enteral nutrition therapy on physical growth and nutritional status in children with Crohn's disease

YANG Min; WU Run-Qiu; CHEN Wen-Xin; QIAO Xue; YANG Hui.

doi:10.7499/j.issn.1008-8830.2404090

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Chinese Journal of Contemporary Pediatrics ›› 2024, Vol. 26 ›› Issue (9) : 933-939. DOI: 10.7499/j.issn.1008-8830.2404090

CLINICAL RESEARCH

Impact of short-peptide exclusive enteral nutrition therapy on physical growth and nutritional status in children with Crohn's disease

YANG Min, WU Run-Qiu, CHEN Wen-Xin, QIAO Xue, YANG Hui.

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Abstract

Objective To evaluate the clinical efficacy of short-peptide exclusive enteral nutrition (EEN) therapy in inducing remission during active Crohn's disease (CD) in children, as well as changes in physical growth and nutritional indicators before and after treatment. Methods A prospective study included 43 children with active CD who were admitted to the Department of Gastroenterology, Children's Hospital of Nanjing Medical University from January 2017 to January 2024. The participants were randomly divided into a medication treatment group (13 children) and a short-peptide + medication treatment group (30 children). The changes in the Pediatric Crohn's Disease Activity Index (PCDAI) scores, physical growth, and nutritional indicators before and after treatment were analyzed in both groups. Results The PCDAI scores in the short-peptide + medication treatment group were lower than those in the medication treatment group after treatment (P<0.05). The Z-scores for weight-for-age, body mass index, and albumin levels were higher in the short-peptide + medication treatment group compared to the medication treatment group (P<0.05). In the patients with moderate to severe CD, total protein levels in the short-peptide + medication treatment group were significantly higher than those in the medication treatment group (P<0.05). Conclusions Short-peptide EEN therapy can induce clinical remission in children with active CD and promote their physical growth while improving their nutritional status.

Key words

Crohn's disease / Short-peptide / Exclusive enteral nutrition / Physical growth / Nutritional status / Child

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YANG Min, WU Run-Qiu, CHEN Wen-Xin, QIAO Xue, YANG Hui.. Impact of short-peptide exclusive enteral nutrition therapy on physical growth and nutritional status in children with Crohn's disease[J]. Chinese Journal of Contemporary Pediatrics. 2024, 26(9): 933-939 https://doi.org/10.7499/j.issn.1008-8830.2404090

References

1 周娟, 肖雄, 夏雨, 等. 炎症性肠病初诊患儿营养状况及影响因素分析[J]. 中国当代儿科杂志, 2023, 25(7): 745-750. PMID: 37529958. PMCID: PMC10414168. DOI: 10.7499/j.issn.1008-8830.2212066.
2 陈晓飞. 营养风险筛查及评估在儿童克罗恩病中的临床应用及护理[D]. 杭州: 浙江大学, 2015.
3 罗优优, 陈洁. 儿童炎症性肠病的营养治疗[J]. 中华实用儿科临床杂志, 2019, 34(7): 485-487. DOI: 10.3760/cma.j.issn.2095-428X.2019.07.002.
4 Wu R, Yang J, Cao J, et al. Efficacy of short-chain polypeptide-based EEN formulas in alleviating intestinal injury in children with Crohn's disease: a single-center study in China[J]. Front Nutr, 2023, 10: 931004. PMID: 37215203. PMCID: PMC10198436. DOI: 10.3389/fnut.2023.931004.
5 Zhang J, Yu WQ, Wei T, et al. Effects of short-peptide-based enteral nutrition on the intestinal microcirculation and mucosal barrier in mice with severe acute pancreatitis[J]. Mol Nutr Food Res, 2020, 64(5): e1901191. PMID: 31965752. DOI: 10.1002/mnfr.201901191.
6 Ibrahim H, Mansour M, El Gendy YG. Peptide-based formula versus standard-based polymeric formula for critically ill children: is it superior for patients' tolerance?[J]. Arch Med Sci, 2020, 16(3): 592-596. PMID: 32399107. PMCID: PMC7212209. DOI: 10.5114/aoms.2020.94157.
7 Shahid N, Salman F, Makhdum M. Major factors responsible for child malnutrition: a review[J]. J Pak Med Assoc, 2021, 71(2(B)): 729-733. PMID: 33941968. DOI: 10.47391/JPMA.1243.
8 Fernández Montes R, Urbano Villaescusa J, Carrillo álvarez á, et al. Effect of three enteral diets with different protein contents on protein metabolism in critically ill infants: a randomized controlled trial[J]. An Pediatr (Engl Ed), 2023, 99(1): 26-36. PMID: 37344303. DOI: 10.1016/j.anpede.2023.03.011.
9 中华医学会儿科学分会消化学组, 中华医学会儿科学分会临床营养学组. 儿童炎症性肠病诊断和治疗专家共识[J]. 中华儿科杂志, 2019, 57(7): 501-507. PMID: 31269548. DOI: 10.3760/cma.j.issn.0578-1310.2019.07.002.
10 程义勇. 《中国居民膳食营养素参考摄入量》2013修订版简介[J]. 营养学报, 2014, 36(4): 313-317. DOI: 10.13325/j.cnki.acta.nutr.sin.2014.04.002.
11 Capriati T, Bizzarri C, Dilillo A, et al. Growth failure in Crohn's disease children: may the first treatment have a role?[J]. Expert Rev Clin Immunol, 2019, 15(1): 97-104. PMID: 30403894. DOI: 10.1080/1744666X.2019.1543590.
12 Duchatellier CF, Kumar R, Krupoves A, et al. Steroid administration and growth impairment in children with Crohn's disease[J]. Inflamm Bowel Dis, 2016, 22(2): 355-363. PMID: 26752463. DOI: 10.1097/MIB.0000000000000669.
13 Djuri? Z, ?aranac L, Budi? I, et al. Therapeutic role of methotrexate in pediatric Crohn's disease[J]. Bosn J Basic Med Sci, 2018, 18(3): 211-216. PMID: 29338679. PMCID: PMC6087553. DOI: 10.17305/bjbms.2018.2792.
14 Atia O, Goren I, Fischler TS, et al. 5-aminosalicylate maintenance is not superior to no maintenance in patients with newly diagnosed Crohn's disease: a nationwide cohort study[J]. Aliment Pharmacol Ther, 2023, 57(9): 1004-1013. PMID: 36894866. DOI: 10.1111/apt.17419.
15 Jongsma MME, Aardoom MA, Cozijnsen MA, et al. First-line treatment with infliximab versus conventional treatment in children with newly diagnosed moderate-to-severe Crohn's disease: an open-label multicentre randomised controlled trial[J]. Gut, 2022, 71(1): 34-42. PMID: 33384335. PMCID: PMC8666701. DOI: 10.1136/gutjnl-2020-322339.
16 Alhagamhmad MH, Day AS, Lemberg DA, et al. Exploring and enhancing the anti-inflammatory properties of polymeric formula[J]. JPEN J Parenter Enteral Nutr, 2017, 41(3): 436-445. PMID: 26826259. DOI: 10.1177/0148607115625627.
17 罗优优, 孙明芳, 楼月, 等. 全肠内营养后嘌呤类药物维持治疗儿童克罗恩病的疗效观察[J]. 中华炎性肠病杂志, 2022, 6(1): 65-69. DOI:10.3760/cma.j.cn101480-20210519-00040.
18 Lecleire S, Hassan A, Marion-Letellier R, et al. Combined glutamine and arginine decrease proinflammatory cytokine production by biopsies from Crohn's patients in association with changes in nuclear factor-kappaB and p38 mitogen-activated protein kinase pathways[J]. J Nutr, 2008, 138(12): 2481-2486. PMID: 19022976. DOI: 10.3945/jn.108.099127.
19 练敏, 吴润秋, 金玉, 等. 经胃镜辅助放置鼻空肠营养管给予肠内营养液在儿科重症疾病中的应用[J]. 中华临床营养杂志, 2018, 26(6): 344-348. DOI: 10.3760/cma.j.issn.1674-635X.2018.06.004.
20 Phipps WS, Greene DN, Pflaum H, et al. Small volume retinol binding protein measurement by liquid chromatography-tandem mass spectrometry[J]. Clin Biochem, 2022, 99: 111-117. PMID: 34678307. PMCID: PMC8671195. DOI: 10.1016/j.clinbiochem.2021.10.005.
21 Ranasinghe RN, Biswas M, Vincent RP. Prealbumin: the clinical utility and analytical methodologies[J]. Ann Clin Biochem, 2022, 59(1): 7-14. PMID: 32429677. DOI: 10.1177/0004563220931885.
22 van Rheenen PF, Aloi M, Assa A, et al. The medical management of paediatric Crohn's disease: an ECCO-ESPGHAN guideline update[J]. J Crohns Colitis, 2020: jjaa161. PMID: 33026087. DOI: 10.1093/ecco-jcc/jjaa161.