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Influence of Exclusive Enteral Nutrition Therapy on Visceral Fat in Patients with Crohn's Disease

Li, Yi MD, PhD; Zhu, Weiming MD, PhD; Gong, Jianfeng MD, PhD; Zuo, Lugen MD; Zhang, Wei MD, PhD; Gu, Lili MD, PhD; Guo, Zhen MD; Cao, Lei MD; Li, Ning MD; Li, Jieshou MD

doi: 10.1097/MIB.0000000000000114
Original Clinical Articles

Background: Mesenteric fat plays an important role in the pathogenesis of Crohn's disease (CD), and a higher ratio of visceral fat area (VFA) to subcutaneous fat area (SFA) is related to complicated disease status. Exclusive enteral nutrition (EEN) is an effective treatment option for patients with CD, and the aims of this study were to assess the effects of EEN on abdominal fat in patients with CD.

Methods: Patient data were obtained from a prospectively maintained database. The SFA and VFA were measured in 38 patients with CD before and after 8-week EEN therapy, and the mesenteric fat index (MFI), defined as the ratio of VFA to SFA, was calculated. The correlations between MFI and CD activity index and C-reactive protein level were also evaluated.

Results: The median age of the patients in our study was 29 years, and the median duration of disease was 3.05 years. Both VFA (P = 0.029) and MFI (P = 0.021) were significantly decreased in patients after EEN, but no significant change was observed in SFA (P = 0.335). MFI was significantly correlated with CD activity index (r = 0.523, P = 0.001) and C-reactive protein (r = 0.634, P < 0.0001) in patients with active CD before EEN, although no positive correlations were observed in patients after EEN treatment.

Conclusions: EEN induction therapy was associated with a significant decrease in VFA in patients with CD, and MFI was significantly correlated with CD activity index and C-reactive protein in active CD. Thus, our data reveal additional beneficial therapeutic mechanisms of enteral nutrition treatment in CD.

Article first published online 30 June 2014.

Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

Reprints: Weiming Zhu, MD, PhD, Department of General surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing 210002, China (e-mail:

Supported in part by National Natural Science Foundation of China (Grants 81200263 and 81170365) and National Ministry of Health for the Digestive Disease (Grant 201002020).

The authors have no conflicts of interest to disclose.

Received May 05, 2014

Accepted May 14, 2014

© Crohn's & Colitis Foundation of America, Inc.
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