Lower skeletal muscle attenuation and high visceral fat index are associated with complicated disease in patients with Crohn's disease: An exploratory study

Cravo, Marília; Velho, S.; Torres, Joana; Santos, Margarida M. Correia dos; Palmela, Carolina; Cruz, Rita; Strecht, J.; Maio, Rui; Baracos, Vickie E.

doi:10.1016/j.clnesp.2017.04.005

Cited by 36 publications

(27 citation statements)

References 25 publications

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“…In CD, the prevalence of sarcopenia was higher than in other autoimmune diseases. It ranged between 31.0 and 61.4% and the median was 40.2% [ 45 , 48 , 50 , 52 , 54 , 55 , 57 , 59 , 61 , 62 ]. There are two reasons why the numbers could have been overestimated.…”

Section: Epidemiology Of Sarcopenia In Autoimmune and Rheumatic DImentioning

confidence: 99%

“…The mechanism of sarcopenia in IBD patients is believed to be associated with disease-related inflammation and nutritional problems. Muscle radiation attenuation, which is an inverse parameter of muscle fat content [ 101 ], has been associated with severe phenotypes of disease such as a history of a stricturing, penetrating complication, or previous resection surgery for CD [ 61 ]. In addition, sarcopenia has been associated with high disease activity assessed by the Mayo score in UC [ 45 ].…”

Section: Inflammatory Bowel Disease and Sarcopeniamentioning

confidence: 99%

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Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Tizaoui

Terrazzino

et al. 2020

IJMS

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Sarcopenia refers to a decrease in skeletal muscle mass and function. Because sarcopenia affects mortality, and causes significant disability, the clinical importance of sarcopenia is emerging. At first, sarcopenia was recognized as an age-related disease but, recently, it has been reported to be prevalent also in younger patients with autoimmune diseases. Specifically, the association of sarcopenia and autoimmune diseases such as rheumatoid arthritis has been studied in detail. Although the pathogenesis of sarcopenia in autoimmune diseases has not been elucidated, chronic inflammation is believed to contribute to sarcopenia, and moreover the pathogenesis seems to be different depending on the respective underlying disease. The definition of sarcopenia differs among studies, which limits direct comparisons. Therefore, in this review, we cover various definitions of sarcopenia used in previous studies and highlight the prevalence of sarcopenia in diverse autoimmune diseases including rheumatoid arthritis, spondyloarthritis, systemic sclerosis, inflammatory bowel disease, and autoimmune diabetes. In addition, we cover the pathogenesis and treatment of sarcopenia in autoimmune and rheumatic diseases. This review provides a comprehensive understanding of sarcopenia in various autoimmune diseases and highlights the need for a consistent definition of sarcopenia.

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Section: Epidemiology Of Sarcopenia In Autoimmune and Rheumatic DImentioning

confidence: 99%

Section: Inflammatory Bowel Disease and Sarcopeniamentioning

confidence: 99%

Sarcopenia in Autoimmune and Rheumatic Diseases: A Comprehensive Review

Tizaoui

Terrazzino

et al. 2020

IJMS

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“…In the future, it is relevant to add other disease outcome parameters, such as flares, change of disease phenotype, hospitalizations, and post‐operative complications and outcomes. These parameters are of interest because CT muscle attenuation radiation, as a parameter related to muscle fat content, has previously been reported to negatively affect duration of hospitalization and readmission rate after intestinal resection in IBD patients 11 and to be associated with a complicated disease phenotype in CD 10 . Because of the small number of patients in the present methodological study, we could not confirm the latter results.…”

Section: Discussionmentioning

confidence: 61%

“…Because of the fat‐saturated post‐contrast T1 images, it was not possible to reliably determine the visceral fat mass, which is a limitation of the present technique. In future studies with larger patient groups, it would be interesting to also measure other parameters of body composition like visceral and subcutaneous fat because these parameters are also reported to correlate with adverse outcomes and complicated disease phenotype in CD on CT 10,29 . There are several limitations of the present study.…”

Section: Discussionmentioning

confidence: 91%

“…Myosteatosis is associated with poor survival in patients with cancer as well as liver cirrhosis 6–9 . In CD, myosteatosis is associated with a more complicated disease phenotype and in IBD patients undergoing a surgical resection with longer hospital stay and readmission within 30 days 10,11 . The effect of myosteatosis on disease outcome parameters over time in CD patients has not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

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The reproducibility of skeletal muscle signal intensity on routine magnetic resonance imaging in Crohn's disease

Spooren

Lodewick

Beelen

et al. 2020

J of Gastro and Hepatol

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Background and Aim Myosteatosis is a prognostic factor in cancer and liver cirrhosis. It can be determined noninvasively using computed tomography or, as shown recently, by magnetic resonance (MR) imaging. The primary aim was to analyze the reproducibility of skeletal muscle signal intensity on routine MR‐enterographies, as indicator of myosteatosis, in Crohn's disease (CD) and to explore the association between skeletal muscle signal intensity at diagnosis with time to intestinal resection. Methods CD patients undergoing MR‐enterography within 6 months from diagnosis and having a maximum of 5 years follow‐up were included. Skeletal muscle signal intensity was analyzed on T1‐weighted fat‐saturated post‐contrast images. Intra‐observer and inter‐observer reproducibilities were assessed by intra‐class correlation coefficient and Cohen's kappa. Intra‐observer and inter‐observer variabilities were determined by Pearson correlation coefficient and displayed by Bland–Altman plots. Time to intestinal resection was studied by Kaplan–Meier analysis. Results Median time between diagnosis and MR‐enterography was 5 weeks (inter‐quartile range 1–9) in 35 CD patients. Skeletal muscle signal intensity showed good intra‐class correlation and substantial agreement (for intra‐observer, intraclass correlation coefficient = 0.948, κ = 0.677; and inter‐observer reproducibility, intraclass correlation coefficient = 0.858, κ = 0.622). Resection free survival was shorter in the low skeletal muscle signal intensity group (P = 0.037). Conclusion Skeletal muscle signal intensity on routine MR‐enterographies is reproducible and was associated with unfavorable disease outcome, indicating potential clinical relevance.

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