The impact of compliance during exclusive enteral nutrition on faecal calprotectin in children with Crohn disease

TY - JOUR

T1 - The impact of compliance during exclusive enteral nutrition on faecal calprotectin in children with Crohn disease

AU - McKirdy, Shona

AU - Russell, Richard K.

AU - Svolos, Vaios

AU - Gkikas, Konstantinos

AU - Logan, Michael

AU - Hansen, Richard

AU - Gerasimidis, Konstantinos

N1 - © 2022 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition This research received funding from Nestle Health Science and the Leona and Harry Helmsley Charitable Trust.

PY - 2022/6

Y1 - 2022/6

N2 - It remains unclear whether suboptimal response to exclusive enteral nutrition (EEN) in some children with Crohn disease (CD) is explained by poor compliance. The present study measured faecal gluten immunogenic peptides (GIP), a biomarker of gluten intake, in 45 children (3– 17 years) with CD, and explored associations with faecal calprotectin (FC) levels at 33 and 54 days of EEN. FC decreased in patients with undetectable GIP at both 33 and 54 days of EEN (mean decrease, 33 days: −743 mg/kg, 54 days: –1043 mg/kg, P< 0.001) but not in patients who had detectable levels. At EEN completion, patients with undetectable GIP had a lower FC by 717 mg/kg compared with patients with a positive GIP result (P = 0.042) and demonstrated a greater decline from baseline FC (–69% vs +5%, P = 0.011). Poorer response to EEN is explained in part by diminished compliance. Faecal GIP might be useful as proxy biomarker of EEN compliance.

AB - It remains unclear whether suboptimal response to exclusive enteral nutrition (EEN) in some children with Crohn disease (CD) is explained by poor compliance. The present study measured faecal gluten immunogenic peptides (GIP), a biomarker of gluten intake, in 45 children (3– 17 years) with CD, and explored associations with faecal calprotectin (FC) levels at 33 and 54 days of EEN. FC decreased in patients with undetectable GIP at both 33 and 54 days of EEN (mean decrease, 33 days: −743 mg/kg, 54 days: –1043 mg/kg, P< 0.001) but not in patients who had detectable levels. At EEN completion, patients with undetectable GIP had a lower FC by 717 mg/kg compared with patients with a positive GIP result (P = 0.042) and demonstrated a greater decline from baseline FC (–69% vs +5%, P = 0.011). Poorer response to EEN is explained in part by diminished compliance. Faecal GIP might be useful as proxy biomarker of EEN compliance.

KW - adherence

KW - biomarkers

KW - children

KW - exclusive enteral nutrition

KW - inflammatory bowel disease

U2 - 10.1097/mpg.0000000000003425

DO - 10.1097/mpg.0000000000003425

M3 - Article

C2 - 35192573

SN - 0277-2116

VL - 74

SP - 801

EP - 804

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

IS - 6

ER -