{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T19:39:11Z","timestamp":1783712351613,"version":"3.55.0"},"reference-count":43,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The presence of sarcopenia has been associated with the worst outcome of Crohn\u2019s disease (CD). At present, no studies have evaluated the impact of ustekinumab (UST) in terms of its effects on body composition. The aim of this prospective study was to evaluate whether UST treatment could modify the parameters of body composition as assessed by bioelectrical impedance assay (BIA) in patients with CD. We prospectively enrolled consecutive patients with CD treated with UST, evaluating the therapeutic outcome at week 48 in terms of clinical remission and mucosal healing. BIA was performed at baseline and at week 48, assessing body cellular mass, total body water, phase angle, and body mass index. Out of 44 patients enrolled, 26 (59%) were in clinical remission and 22 (50%) achieved mucosal healing at the end of follow up. No significant differences were observed at baseline in all the BIA parameters between responders and non-responders. Phase angle increased over time in responders, while this was not observed in non-responders (test for the interaction between time and outcome, p-value = 0.009 and 0.007 for clinical remission and mucosal healing, respectively). The same differential increase was observed for body cellular mass (test for the interaction between time and outcome, p-value = 0.03 and 0.05 for clinical remission and mucosal healing, respectively). Total body water and BMI increased homogenously over time regardless of the outcomes (tests for the association with time, p-values of 0.01). To conclude, responsiveness to UST therapy seems to be associated with body composition modifications in patients with CD. In particular, the increase in phase angle in responders suggests that a significant improvement of nutritional status occurred in these patients.<\/jats:p>","DOI":"10.3390\/jcm12196118","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T03:44:42Z","timestamp":1695354282000},"page":"6118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Response to Ustekinumab Therapy Is Associated with an Improvement of Nutritional Status in Patients with Crohn\u2019s Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8653-1790","authenticated-orcid":false,"given":"Lorenzo","family":"Bertani","sequence":"first","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"},{"name":"Tuscany North West ASL, Department of General Surgery and Gastroenterology, Pontedera Hospital, Via Roma, 147, 56025 Pontedera, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2313-5461","authenticated-orcid":false,"given":"Claudia","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Fornili","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Coppini","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Zanzi","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6263-3864","authenticated-orcid":false,"given":"Luca","family":"Carmisciano","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Geri","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Baiano","family":"Svizzero","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma Maria","family":"Rosi","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"De Bernardi","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Gloria","family":"Mumolo","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Baglietto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6387-6443","authenticated-orcid":false,"given":"Massimo","family":"Bellini","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-1060","authenticated-orcid":false,"given":"Nicola","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma, 67, 56100 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9150-3345","authenticated-orcid":false,"given":"Francesco","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Gastroenterology, IBD Unit, Pisa University Hospital, Via Paradisa, 2, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1038\/sj.ejcn.1601049","article-title":"Comprehensive nutritional status in recently diagnosed patients with inflammatory bowel disease compared with population controls","volume":"54","author":"Geerling","year":"2000","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/S0140-6736(07)60751-X","article-title":"Inflammatory bowel disease: Clinical aspects and established and evolving therapies","volume":"369","author":"Baumgart","year":"2007","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/ibd.21417","article-title":"Long-term complications, extraintestinal manifestations, and mortality in adult Crohn\u2019s disease in population-based cohorts","volume":"17","author":"Loftus","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Balestrieri, P., Ribolsi, M., Guarino, M.P.L., Emerenziani, S., Altomare, A., and Cicala, M. (2020). Nutritional Aspects in Inflammatory Bowel Diseases. Nutrients, 12.","DOI":"10.3390\/nu12020372"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/apt.12372","article-title":"Systematic review: Body composition in adults with inflammatory bowel disease","volume":"38","author":"Bryant","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.nut.2008.03.018","article-title":"Malnutrition and impaired muscle strength in patients with Crohn\u2019s disease and ulcerative colitis in remission","volume":"24","author":"Valentini","year":"2008","journal-title":"Nutrition"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3548284","DOI":"10.1155\/2019\/3548284","article-title":"Assessment of Body Composition in Health and Disease Using Bioelectrical Impedance Analysis (BIA) and Dual Energy X-Ray Absorptiometry (DXA): A Critical Overview","volume":"2019","author":"Marra","year":"2019","journal-title":"Contrast Media Mol. Imaging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1038\/ejcn.2014.67","article-title":"Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients","volume":"68","author":"Beberashvili","year":"2014","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Han, B.G., Lee, J.Y., Kim, J.S., and Yang, J.W. (2018). Clinical Significance of Phase Angle in Non-Dialysis CKD Stage 5 and Peritoneal Dialysis Patients. Nutrients, 10.","DOI":"10.3390\/nu10091331"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1038\/ejcn.2015.126","article-title":"The value of bioelectrical impedance analysis and phase angle in the evaluation of malnutrition and quality of life in cancer patients\u2014A comprehensive review","volume":"69","author":"Grundmann","year":"2015","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1007\/s00134-016-4468-3","article-title":"Fat-free mass at admission predicts 28-day mortality in intensive care unit patients: The international prospective observational study Phase Angle Project","volume":"42","author":"Thibault","year":"2016","journal-title":"Intensive Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Wiech, P., Dabrowski, M., Bazalinski, D., Salacinska, I., Korczowski, B., and Binkowska-Bury, M. (2018). Bioelectrical Impedance Phase Angle as an Indicator of Malnutrition in Hospitalized Children with Diagnosed Inflammatory Bowel Diseases-A Case Control Study. Nutrients, 10.","DOI":"10.3390\/nu10040499"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Mentella, M.C., Scaldaferri, F., Pizzoferrato, M., Gasbarrini, A., and Miggiano, G.A.D. (2019). The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD. Nutrients, 11.","DOI":"10.3390\/nu11112583"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/ibd\/izy212","article-title":"Sarcopenia and Inflammatory Bowel Disease: A Systematic Review","volume":"25","author":"Ryan","year":"2019","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Caio, G., Lungaro, L., Caputo, F., Zoli, E., Giancola, F., Chiarioni, G., De Giorgio, R., and Zoli, G. (2021). Nutritional Treatment in Crohn\u2019s Disease. Nutrients, 13.","DOI":"10.3390\/nu13051628"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1080\/14712598.2018.1419183","article-title":"Effect of anti IL-12\/23 on body composition: Results of bioelectrical impedance analysis in Caucasian psoriatic patients","volume":"18","author":"Galluzzo","year":"2018","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1056\/NEJMoa1602773","article-title":"Ustekinumab as Induction and Maintenance Therapy for Crohn\u2019s Disease","volume":"375","author":"Feagan","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1056\/NEJMoa1900750","article-title":"Ustekinumab as Induction and Maintenance Therapy for Ulcerative Colitis","volume":"381","author":"Sands","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1080\/14712598.2020.1707800","article-title":"Effectiveness and safety of Ustekinumab for the treatment of Crohn\u2019s disease in real-life experiences: A meta-analysis of observational studies","volume":"20","author":"Macaluso","year":"2020","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/ecco-jcc\/jjz180","article-title":"ECCO Guidelines on Therapeutics in Crohn\u2019s Disease: Medical Treatment","volume":"14","author":"Torres","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ajcn\/48.1.16","article-title":"Bioelectric impedance phase angle and body composition","volume":"48","author":"Baumgartner","year":"1988","journal-title":"Am. J. Clin."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Bertani, L., Ribaldone, D.G., Bellini, M., Mumolo, M.G., and Costa, F. (2021). Inflammatory Bowel Diseases: Is There a Role for Nutritional Suggestions?. Nutrients, 13.","DOI":"10.3390\/nu13041387"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"694217","DOI":"10.3389\/fimmu.2021.694217","article-title":"Inflammatory Bowel Diseases and Sarcopenia: The Role of Inflammation and Gut Microbiota in the Development of Muscle Failure","volume":"12","author":"Nardone","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1677\/JOE-07-0606","article-title":"Mechanisms of glucocorticoid-induced myopathy","volume":"197","author":"Schakman","year":"2008","journal-title":"J. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/00001574-200107000-00008","article-title":"Nutrition in inflammatory bowel disease: Impact on disease and therapy","volume":"17","author":"Cabre","year":"2001","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bamba, S., Sasaki, M., Takaoka, A., Takahashi, K., Imaeda, H., Nishida, A., Inatomi, O., Sugimoto, M., and Andoh, A. (2017). Sarcopenia is a predictive factor for intestinal resection in admitted patients with Crohn\u2019s disease. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0180036"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1097\/MIB.0000000000001166","article-title":"Sarcopenia is a Predictor of Surgical Morbidity in Inflammatory Bowel Disease","volume":"23","author":"Pedersen","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1038\/ejcn.2017.10","article-title":"Low muscle mass at initiation of anti-TNF therapy for inflammatory bowel disease is associated with early treatment failure: A retrospective analysis","volume":"71","author":"Holt","year":"2017","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN guidelines on definitions and terminology of clinical nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/MCO.0000000000000496","article-title":"Bioelectrical impedance analysis in the assessment of sarcopenia","volume":"21","author":"Gonzalez","year":"2018","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Pizzoferrato, M., de Sire, R., Ingravalle, F., Mentella, M.C., Petito, V., Martone, A.M., Landi, F., Miggiano, G.A.D., Mele, M.C., and Lopetuso, L.R. (2019). Characterization of Sarcopenia in an IBD Population Attending an Italian Gastroenterology Tertiary Center. Nutrients, 11.","DOI":"10.3390\/nu11102281"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"321","DOI":"10.5217\/ir.2021.00022","article-title":"Evaluation of nutritional status using bioelectrical impedance analysis in patients with inflammatory bowel disease","volume":"20","author":"Kim","year":"2021","journal-title":"Intest. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1016\/j.clnu.2004.06.004","article-title":"Bioelectrical impedance analysis\u2014part I: Review of principles and methods","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Peng, Z., Xu, D., Li, Y., Peng, Y., and Liu, X. (2022). Phase Angle as a Comprehensive Tool for Nutritional Monitoring and Management in Patients with Crohn\u2019s Disease. Nutrients, 14.","DOI":"10.3390\/nu14112260"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/apt.13058","article-title":"Infliximab reverses inflammatory muscle wasting (sarcopenia) in Crohn\u2019s disease","volume":"41","author":"Subramaniam","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_36","first-page":"495","article-title":"Nutritional status and bioelectrical phase angle assessment in adult Crohn disease patients receiving anti-TNFalpha therapy","volume":"49","author":"Emerenziani","year":"2017","journal-title":"Dig. Liver Dis. Off. J. Ital. Soc. Gastroenterol. Ital. Assoc. Study Liver"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"492","DOI":"10.2340\/00015555-0711","article-title":"Excessive body weight and smoking associates with a high risk of onset of plaque psoriasis","volume":"89","author":"Wolk","year":"2009","journal-title":"Acta Derm.-Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1159\/000455840","article-title":"Psoriasis and Obesity","volume":"232","author":"Jensen","year":"2016","journal-title":"Dermatology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1093\/ecco-jcc\/jjaa189","article-title":"Week 6 Calprotectin Best Predicts Likelihood of Long-term Endoscopic Healing in Crohn\u2019s Disease: A Post-hoc Analysis of the UNITI\/IM-UNITI Trials","volume":"15","author":"Narula","year":"2021","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e00174","DOI":"10.14309\/ctg.0000000000000174","article-title":"Fecal Calprotectin Predicts Mucosal Healing in Patients with Ulcerative Colitis Treated with Biological Therapies: A Prospective Study","volume":"11","author":"Bertani","year":"2020","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_41","first-page":"733","article-title":"Are clinical trial results transferable in the real life?","volume":"84","author":"Natale","year":"2016","journal-title":"Monaldi Arch. Chest Dis. Arch. Monaldi Mal. Torace"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.crohns.2009.09.008","article-title":"Does fecal calprotectin predict relapse in patients with Crohn\u2019s disease and ulcerative colitis?","volume":"4","author":"Gisbert","year":"2010","journal-title":"J. Crohns Colitis"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3681","DOI":"10.3748\/wjg.v24.i33.3681","article-title":"From bench to bedside: Fecal calprotectin in inflammatory bowel diseases clinical setting","volume":"24","author":"Mumolo","year":"2018","journal-title":"World J. Gastroenterol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6118\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:55:33Z","timestamp":1760129733000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/19\/6118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,22]]},"references-count":43,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["jcm12196118"],"URL":"https:\/\/doi.org\/10.3390\/jcm12196118","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,22]]}}}