Approximately 1 in 10 ambulatory inflammatory bowel disease patients are at risk of malnutrition: A prospective Singapore cohort

Objectives: Prevalence of malnutrition among ambulatory inflammatory bowel disease (IBD) patients in Singapore is unknown. We aimed to evaluate the prevalence of ambulatory IBD patients at risk of malnutrition (ARMN) using Malnutrition Universal Screening Tool (MUST) and its clinical outcomes. Methods: IBD patients were recruited from March to June 2018 and followed up for 6 months. ARMN patients were defined as having a MUST score of 2 or more compared with those not at risk (non-ARMN). Results: Altogether 217 patients were recruited, including 128 (59.0%) with ulcerative colitis (UC) and 89 (41.0%) with Crohn's disease (CD). The mean body mass index (BMI) was 23.5 +/- 4.5 kg/m(2); 35 (16.1%) patients were on biologics, and 52 (24.0%) were on steroids. Among them 25 (11.5%) patients were ARMN, with a predominance of UC (n = 15, 60.0%). The majority of ARMN patients were underweight (n = 23, 92.0%) while 114 (59.4%) non-ARMN patients were overweight. ARMN patients had a significantly lower albumin (38.3 g/L vs 41.9 g/L) and a significantly increased proportion of patients with C-reactive protein >= 5 mg/L (36.0% vs 19.3%). There was a trend towards longer hospital stay among ARMN patients, although this was not statistically significant. Use of biologics or immunomodulators and albumin levels were associated with being ARMN. Conclusion: Using MUST, 11.5% of our ambulatory IBD patients in Singapore were identified to be ARMN. Among ARMN patients, a trend was demonstrated towards a longer hospital stays for admitted patients. This underscores the need to actively screen ambulatory IBD patients for malnutrition.