When metabolic comorbidities and risk of malnutrition coexist: The new era of inflammatory bowel disease.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) and risk of malnutrition can coexist in patients with inflammatory bowel disease (IBD). We performed a malnutrition risk assessment as part of the standard follow-up of IBD patients and studied the potential risk factors for being at risk of malnutrition based on the presence or absence of MASLD. METHODS: The Malnutrition Universal Screening Tool (MUST) was used to screen malnutrition risk (MUST ≥ 1) and controlled attenuation parameter (CAP ≥ 248 dB/min) to assess MASLD. Adherence to a Mediterranean diet, physical activity, and quality of life were also assessed. RESULTS: Of 686 evaluated IBD patients, 130 (18.9%) were identified as being at risk of malnutrition. Patients without MASLD (n=89 [68.5%]) were more likely to be at risk than those with MASLD (n=41 [31.5%], p=0.005). However, among patients at risk of malnutrition, those with MASLD were more likely to have active IBD (82.9%) than patients without MASLD (39.3%, p<0.001). Female sex (OR 1.984, p=0.027) and young age (OR 1.014, p=0.006) were associated with malnutrition risk only in patients with IBD without MASLD. Being at risk of malnutrition was associated with worse quality of life (p<0.001), especially in IBD patients with MASLD. CONCLUSIONS: Malnutrition risk and quality of life are modified by the presence of MASLD in IBD patients.