Altered subjective appetite parameters in Crohnʹs disease patients

Background and Aim: Altered appetite and early satiety may promote anorexia associated with Crohnʹs disease. The aim of this study was to assess the impact of disease activity on subjective appetite parameters in Crohnʹs disease patients. Methods: Seventeen patients with Crohnʹs disease and 15 healthy controls (8 M: 7 F, 34 (20–35) years) were studied. Subjects rated their hunger, desire to eat, fullness and level of satiety using visual analogue scales after an overnight fast. Subjects were reassessed after ingestion of 500 and 1000 ml water. Anthropometry was used to determine percentage body fat. Serum leptin & TNF- α levels were assessed using immunoassay. Disease activity was determined using the Harvey–Bradshaw index. Results: Hunger ratings for active Crohnʹs disease patients were significantly lower than controls at baseline (P<0.05). Desire to eat was lower in patients with active Crohnʹs disease than controls both at baseline (95% CI, 0.3 mm, 40.7 mm) and after ingestion of 500 ml water (95% CI, 1.25 mm, 51.9 mm) (P<0.05). Serum leptin concentrations were significantly associated with percent body fat (r=0.57;P<0.001) and, after correcting for body fat status, tended to be higher in patients with active Crohnʹs disease (mean 0.9 ng/ml/% body fat; SD 0.8 ng/ml/% body fat) compared with either patients with inactive disease (mean 0.4 ng/ml/% body fat; SD 0.3 ng/ml/% body fat) or healthy controls (mean 0.3 ng/ml/% body fat; SD 0.2 ng/ml/% body fat) (P=0.15, ns). Appetite parameters and serum leptin concentrations showed no significant correlation. Conclusions: Subjective appetite parameters were altered in patients with active Crohnʹs disease. At baseline, patients with active Crohnʹs disease were less hungry than healthy controls and had less desire to eat. After ingestion of 500 ml of water, desire to eat was significantly less in patients with active disease as compared with healthy controls. Serum leptin concentration corrected for percent body fat tended to be higher in patients with active Crohnʹs disease compared with inactive Crohnʹs disease and healthy controls, but the differences did not reach statistical significance.