Reduced skeletal muscle protein balance in paediatric Crohn’s disease

Davies, Amanda; Nixon, Aline; Muhammed, Rafeed; Tsintzas, Kostas; Kirkham, Sian; Stephens, Francis B.; Moran, Gordan W.

Abstract

Background and Aims
An inability to respond to nutrition could be implicated in low muscle mass in Crohn’s disease. We aim to determine skeletal muscle metabolic response to feeding in Crohn’s disease and healthy volunteers.

Methods
Twenty asymptomatic Crohn’s disease participants (15.6 ± 0.5 yrs; BMI 20.6 ± 0.9 kg/m2); 9 with active disease (faecal calprotectin, 808 ± 225ug/g and C-reactive protein, 2.2 ± 1.2 mg/dl), 11 in deep remission (faecal calprotectin, 61 ± 12ug/g and C-reactive protein, 0.3 ± 0.2 mg/dl) and 9 matched healthy volunteers (16.0±0.6 yrs; BMI 20.7±0.6 kg/m2) were recruited. Participants had a dual energy X-ray absorptiometry scan, handgrip dynamometer test, wore a pedometer and completed a food diary. Arterialised hand and venous forearm blood samples were collected concurrently and brachial artery blood flow measured at baseline and every 20mins for 2hrs after the ingestion of a standardised liquid meal. Net balance of branched chain amino acids and glucose were derived.

Results
Controls had a positive mean BCAA balance. CD participants had an initial anabolic response to the meal, with increasing BCAA balance between t=0 & t=20, but returned to negative by t=60. This was associated with reduced FFM z-scores in CD but not with insulin resistance or disease activity. Exploratory analyses suggest that negative postprandial BCAA response seen in CD is predominant in males (p=0.049), with associated lower appendicular muscle mass (p=0.034), higher muscle fatigue (p=0.014) and reduced protein intake (p=0.026).

Conclusions
The inability to sustain a positive protein balance postprandially could provide an explanation for the reduced muscle mass seen in CD. Further mechanistic studies will be needed to confirm these findings.

Citation

Davies, A., Nixon, A., Muhammed, R., Tsintzas, K., Kirkham, S., Stephens, F. B., & Moran, G. W. (2020). Reduced skeletal muscle protein balance in paediatric Crohn’s disease. Clinical Nutrition, 39(4), 1250-1257. https://doi.org/10.1016/j.clnu.2019.05.017

• Journal Article Type: Article
• Acceptance Date: May 16, 2019
• Online Publication Date: May 25, 2019
• Publication Date: 2020-04
• Deposit Date: May 22, 2019
• Publicly Available Date: May 26, 2020
• Journal: Clinical Nutrition
• Print ISSN: 0261-5614
• Electronic ISSN: 1532-1983
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 39
• Issue: 4
• Pages: 1250-1257
• DOI: https://doi.org/10.1016/j.clnu.2019.05.017
• Keywords: Crohn’s disease; Inflammatory Bowel Disease; Nutrition; Sarcopenia
• Public URL: https://nottingham-repository.worktribe.com/output/2082276
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0261561419302286
• Contract Date: May 30, 2019