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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Gut Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1395686
This article is part of the Research Topic Insights in Gut Endocrinology View all 6 articles

Metabolic stress in patients with acute severe ulcerative colitis -a single-center cohort study

Provisionally accepted
Mathias Redsted Mathias Redsted 1,2*Magnus Grønhøj Magnus Grønhøj 1,2Louise D. Brøchner Louise D. Brøchner 1,2Janne L. Fassov Janne L. Fassov 2Mads V. Svart Mads V. Svart 3Jens R. Andersen Jens R. Andersen 1Christian L. Hvas Christian L. Hvas 2
  • 1 Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Capital Region of Denmark, Denmark
  • 2 Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
  • 3 Steno Diabetes Center Aarhus & Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark

The final, formatted version of the article will be published soon.

    Background and Aims: Acute severe ulcerative colitis (ASUC) is characterized by systemic inflammation, which may initiate an acute-phase response leading to hypercatabolism. Patients with ASUC are usually treated with high-dose steroids that may further accelerate the metabolic response and lead to hyperglycemia and insulin resistance. Nevertheless, the degree of synergy between inflammation and steroid treatment and their influence on the insulin resistance remains unknown. We aimed to measure the degree of metabolic stress including insulin resistance in patients with ASUC during admission and three weeks after discharge. Methods: This single-center cohort study was conducted in adult patients with ASUC, defined and assessed by Truelove and Witt's criteria. Indirect calorimetry, bioelectrical impedance analysis, and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were applied at baseline and at follow-up three weeks after discharge. Results: Among the 22 patients admitted during the project period, 15 provided consent for participation in the study. Median C-reactive protein at inclusion was 37.6 [4; 154.7].Both median HOMA-IR and fasting plasma glucose were markedly increased at inclusion (median 8.6 [3.8; 14.1] and 7.1 [6; 8.7], respectively), and both had decreased significantly three weeks after discharge (p=0.0036 and p=0.0039, respectively). No significant differences were observed in resting energy expenditure or anthropometric measurements from baseline to follow-up. Conclusion: Patients with ASUC presented with marked insulin resistance, indicating that the days following admission and high-dose steroid treatment are particularly vulnerable. Despite improvement at three-week follow-up, patients still exhibited insulin resistance compared with relevant control groups.

    Keywords: Colitis, Ulcerative, Basal Metabolism, Metabolic Stress, Insulin resistance, Prednisolone. Trial registration: ClinicalTrials.gov, study identifier NCT0527183 ASUC, acute severe ulcerative colitis, BIA, bioelectrical impedance analysis, CRP, C-reactive protein, HEC, hyperinsulinemia euglycemia clamp, HOMA-IR, the Homeostatic Model Assessment for Insulin Resistance

    Received: 04 Mar 2024; Accepted: 16 Oct 2024.

    Copyright: © 2024 Redsted, Grønhøj, Brøchner, Fassov, Svart, Andersen and Hvas. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mathias Redsted, Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, 1017, Capital Region of Denmark, Denmark

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.