Diagnostic Criteria and Prognostic Relevance of Sarcopenia in Patients with Inflammatory Bowel Disease—A Systematic Review

Abstract

Background: Sarcopenia is a syndrome characteristic in elderly patients and is also associated with a significant proportion of chronic disorders such as inflammatory bowel disease (IBD). In this case, it can lead to a worse prognosis of the disease and a decreased quality of life. Study Aim: This study aims to identify the best ways to diagnose sarcopenia in patients with IBD, establish its impact on the course of the disease, and find preventive methods to counteract the effects of sarcopenia in the outcome of patients with IBD and, therefore, minimize disabilities and increase the health-related quality of life (HRQoL). Material and Methods: A systematic review with the Prospero registration number CRD42023398886 was performed in PubMed and Web of Science databases, evaluating all original articles published in the last 10 years (clinical trials and randomized control trials) that describe sarcopenia and IBD in the human adult population. Results: From the 16 articles that were included, 5 articles defined sarcopenia by the skeletal muscle index (SMI) and reported data regarding its correlation with body composition: BMI; visceral fat (VF); subcutaneous fat (SC); and VF/SC index. Other articles evaluated the link between sarcopenia and the total psoas muscle area, thigh circumference, calf circumference, subjective global assessment, hand grip strength, and appendicular SMI, alongside inflammatory markers such as IL-6 and C-reactive protein, level of disability, malnutrition, frailty, resistance training alone and in combination with whey protein, and infliximab treatment. Discussions and Conclusions: There is a great heterogeneity regarding the assessment criteria and methods used to diagnose sarcopenia due to the variability of population characteristics, both anthropometric and socio-cultural, alongside the high variability in the cut-offs. Therefore, any method which identifies sarcopenia in IBD patients, thus enabling intervention, may provide good results for patient quality of life and outcomes.

Multimodal Prehabilitation for Patients with Crohn’s Disease Scheduled for Major Surgery: A Narrative Review

“…A recent systematic review of 18 studies found that the prevalence of sarcopenia among CD patients, ranges from 16 to 100%, and is higher than 50% in more than half of the included studies. This large variability might be explained by the lack of a universal definition of sarcopenia, by the anthropometric and socio-cultural heterogeneity of the population of interest, alongside with the high variability of muscle mass indices and thresholds used to identify sarcopenic patients [ 44 ]. The European Working Group on Sarcopenia in Older People (EWGSOP) identifies low muscle strength, and low muscle quantity and quality as mandatory features to diagnose sarcopenia; physical performance status is used to quantify the severity of sarcopenia [ 45 ].…”

Assessing the Effectiveness of Rehabilitation Interventions through the World Health Organization Disability Assessment Schedule 2.0 on Disability—A Systematic Review

“…In the realm of rehabilitation, interventions vary widely, encompassing several key aspects. Firstly, there are goal-oriented treatments tailored to alter the trajectory of a condition [ 14 ]. Secondly, a focus on reducing activity limitations is crucial, involving specific measures such as spasticity reduction [ 15 ].…”