Low muscle mass and sarcopenia: common and predictive of osteopenia in inflammatory bowel disease

Abstract

Low lean mass and sarcopenia are common in patients with IBD, and important to recognise as they predict osteopenia/osteoporosis. Grip strength testing should be incorporated into routine clinical practice to detect low lean mass deficits, which may go unrecognised using BMI alone.

Impact of biological therapy on body composition of patients with Chron's disease

“…13,14 In addition to malnutrition, changes in body composition such as the occurrence of sarcopenia have been described in patients with CD. [15][16][17][18] Schneider et al describe the occurrence of sarcopenia in 60% of patients with CD even during clinical remission. 18 Loss of lean mass (LM) has been associated with worsening of bone mineral density, increased morbidity, loss of muscle strength, and increased risk of infectious complications.…”

Nutritional support and dietary interventions for patients with ulcerative colitis: current insights

“…These relationships support this criticism of using albumin as a marker of nutritional status, as any relationship between serum albumin and nutritional status may simply be a reflection of more severe inflammatory illness, rather than an indicator of nutritional compromise. Interestingly, Bryant et al 14 found low serum albumin (,34 g/dL) in only 7% of their cohort with UC, whereas 26% were found to have reduced functional lean mass according to the ASM index. Sixty-four percent of their patients had active disease.…”

“…These changes, suggestive of malnutrition, were not related to disease location, duration, or activity. More recently, utilizing dual-energy X-ray absorptiometry, Bryant et al 14 described appendicular skeletal muscle (ASM) mass, as a reflection of true muscles mass in adult patients with UC. Of their cohort of 42 patients, 26% demonstrated an ASM index ,1 standard deviation and were considered to have low lean mass; however, fat mass was not considered reduced.…”

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“…However, Bryant et al [8] noted an odds ratio of 2.03 for sarcopaenia in older patients who had received more than 12 months of steroid treatment, and Jahnsen et al [29] saw a decrease of lean tissue mass that was concentrated in patients who had received steroids. [60] 106 cases of CD (adults, > 1 yr duration), 75 age- & sex-matched previously healthy acute hospital admissions with illness of < 28 days duration…”