Magnetic resonance imaging assessment of body composition parameters in Crohn's disease

Labarthe, Ghislain; Dolores, Michael; Verdalle-Cazes, Mikael; Charpentier, C; Roullee, Pauline; Dacher, Jean‐Nicolas; Savoye, Guillaume; Savoye‐Collet, Céline

doi:10.1016/j.dld.2020.06.024

Cited by 14 publications

(12 citation statements)

References 88 publications

(62 reference statements)

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“…In contrast, in our study, TATI, SATI, and VATI did not differ between the groups of complicated and inflammatory disease (p = 0.14, p = 0.17, and p = 0.33, respectively). Our results are in line with Labarthe et al [15], showing no significant difference in VATI (p = 0.34) among CD patients with active compared to inactive disease. The further categorization of our population based on sex-specific cutoff values of SATI (low/normal vs. high SATI) and (low/normal vs. high VATI) did not predict the occurrence of any specific complication (fistulae, abscesses, or strictures).…”

Section: Discussionsupporting

confidence: 93%

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Body Composition Predictors of Complicated Crohn’s Disease

Ordonez

Melekh

Rodríguez-Feria

et al. 2023

Dig Dis

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Background: High visceral adipose tissue (VAT) and creeping fat (CrF) in Crohn's disease (CD) have been widely recognized. The VAT to subcutaneous adipose tissue (SAT) ratio and sarcopenia have been associated with CD complications. Studies regarding the influence of body composition predictors on CD complications assessed with magnetic resonance enterography (MRE) are scarce. Aim: Assessment of the body composition parameters and CrF in opportunistic MRE as predictors of complicated CD. Methods: This was a retrospective study of 114 patients with inflammatory (n = 54) and complicated (n = 60) CD. The semi-automated assessment of body composition and the qualitative evaluation of CrF were performed. Results: Body composition parameters did not differ between both groups regarding the body mass index (BMI) (p =0.50), total adipose tissue index (TATI) (p =0.14), subcutaneous adipose tissue index (SATI) (p =0.17), visceral adipose tissue index (VATI) (p =0.33), VAT/SAT ratio (p =0.77), intramuscular adipose tissue (IMAT) (p =0.64), skeletal muscle index (SMI) (p =0.22), and sarcopenia (p =0.50). 47 strictures, 18 fistulae, and seven abscesses were identified. Fistulae were more likely to occur in patients with CrF (odds ratio [OR] 5.07, 95% confidence interval [CI] 1.76–14.56; p=<0.001) and high VAT/SAT ratio (OR: 3.82, 95% CI 1.34–10.85; p=0.01). Conclusion: Body composition measurements in CD patients displayed no statistically significant difference between the groups of inflammatory and complicated disease. Nonetheless, CD patients stratified in the group of high VAT/SAT ratio and the presence of CrF should be recognized as risk groups for the occurrence of fistulae.

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Section: Discussionsupporting

confidence: 93%

“…As described by Labarthe et al [15] MRI measurements of body composition parameters are feasible and reproducible, particularly with the help of semiautomated methods. MRE has a higher accuracy in detecting CrF and fistula than CT; the avoidance of radiation exposure Dig Dis 2023;41:589-599 DOI: 10.1159/000529426 is also an advantage [23].…”

Section: Discussionmentioning

confidence: 99%

Body Composition Predictors of Complicated Crohn’s Disease

Ordonez

Melekh

Rodríguez-Feria

et al. 2023

Dig Dis

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“…The present study showed that the ΔVA/TA index was positively correlated with the trends in CRP, ESR, and total MRE score ( r = 0.355, p < 0.05; r = 0.332, p < 0.05; r = 0.479, p < 0.01), while ΔSAI was negatively correlated with Δtotal MRE score ( r = − 0.320, p < 0.05). Labarthe et al [ 13 ] also observed that active/severe CD patients had a higher VA/TA index and lower SAI than inactive patients, similar to the present results. Still, we focus more on analysing changes in disease over treatment, which is more applicable to monitoring during follow-up.…”

Section: Discussionsupporting

confidence: 92%

“…A link was found between MRI-based body composition parameters and inflammatory status in CD patients. For example, Büning et al [ 12 ] found a higher proportion of VAT in women with CD than control women; Labarthe et al [ 13 ] also found a higher proportion of VAT in patients with active CD compared to inactive patients. However, the former study group was all female, while the latter was a cross-sectional comparison of patients with different levels of activity, and few studies have assessed patients longitudinally by monitoring both changes in body composition and inflammatory status assessed by MRI during follow-up, that is, the association between changes of MRI-based body composition and changes of disease activity during treatment was still unclear.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging-based body composition is associated with nutritional and inflammatory status: a longitudinal study in patients with Crohn's disease

et al. 2021

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Objective To evaluate the changes in magnetic resonance imaging-based body composition parameters during follow-ups in patients with Crohn's disease (CD). Methods Between November 1, 2017, and June 30, 2021, patients diagnosed with CD, who underwent two or more magnetic resonance enterography (MRE) scans at our institution were retrospectively reviewed. The baseline and one subsequent follow-up scan for each patient were paired to form longitudinal comparisons. Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) indexes were calculated from tissue areas measured at the third lumbar vertebra level per scan, standardized by dividing the height2 and lumbar height2 (heightL1–L5). We also assessed the correlation between changes in VAT to total adipose tissue ratio (VA/TA index) and CD activity scores (5-point MRE classification) using Spearman’s correlation analysis. A multivariate linear regression model was used to adjust for the follow-up duration and treatment type. Results Overall, 49 patients (with 49 paired scans) were enrolled. VA/TA index changes were negatively correlated with changes in skeletal muscle index (SMI; r = − 0.339, p < 0.05). The VA/TA index (52.69 ± 10.66% vs. 49.18 ± 10.80%, p < 0.001) and the total MRE score (8.0 ± 3.9 vs. 5.7 ± 3.4, p < 0.001) decreased significantly during follow-up, regardless of follow-up duration and treatment type (both p > 0.05). Changes in total MRE score were negatively correlated with SMI changes (r = − 0.408, p < 0.01) but positively correlated with VA/TA index changes (r = 0.479, p < 0.01). Conclusion An increase in SMI and a decrease in VA/TA index could reflect improved nutritional and inflammatory status.

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“…First, 110 patients with IBD were included in the study cohort, which is more than in previous studies (36)(37)(38). Second, this study used the AWGS2019 criteria to diagnose sarcopenia, which is novel, as few studies of sarcopenia have used this approach (36)(37)(38)(39)(40). Third, this study also found that low BMI and low Alb levels were risk factors for developing sarcopenia.…”

Section: Discussionmentioning

confidence: 83%

Sarcopenia is associated with poor clinical outcomes in patients with inflammatory bowel disease: a prospective cohort study

Liu¹,

Ding²,

Maggiore³

et al. 2022

Ann Transl Med

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Background: Patients with inflammatory bowel disease (IBD) often have low weight, malnutrition and sarcopenia. The criteria of sarcopenia used were European and American standards previously. The aim of the study was to evaluate the impact of sarcopenia on clinical outcomes in patients with IBD using the Asian Working Group for Sarcopenia 2019 (AWGS2019) criteria. Methods:The inclusion of the subjects was IBD patients between 18 to 60 years. Sarcopenia, presarcopenia and sarcopenic obesity were defined. Participants were followed up for 90 days. Information as to whether the symptoms improved, treatment plans changed, underwent surgery, were readmitted to the hospital, or died was recorded. Analyses of chi-square test, t-test, cumulative survival analysis and receiver operating characteristic (ROC) curves were done through SPSS25.0 software. Odds ratio (OR) and 95% confidence interval (CI) were calculated.Results: A total of 110 patients with IBD were included. The prevalence of pre-sarcopenia was 44.6% and of sarcopenia 50.8%. Body mass index (BMI) (P=0.018; OR =0.449) and albumin (Alb) levels were lower (P=0.004; OR =0.608) in the sarcopenia group than the control and pre-sarcopenia groups, and they were risk factors for sarcopenia. Meanwhile, a history of more frequent alcohol consumption, parenteral manifestations, IBD-related complications, higher C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significant statistic different for sarcopenia group compared with others. Rates of surgery (P<0.001; OR =6.651), re-hospitalization (P<0.001; OR =6.344) or death (P=0.003) were higher in the sarcopenia group than in the control group. The sarcopenia group had higher rates of surgery (P=0.022; OR =3.608) and re-hospitalization (P=0.048; OR =5.500) than the pre-sarcopenia group after adjustment analysis.Patients in the sarcopenic obesity group with body fat percentages ≥24.8% (P=0.039; 95% CI: 0.590-1.000) in men and ≥32.0% (P=0.006; 95% CI: 0.692-1.000) in women were more likely to receive surgery, female patients with that ≥24.5% (P=0.025; 95% CI: 0.556-1.000) were more likely to experience re-hospitalization.Conclusions: Patients with IBD diagnosed with sarcopenia or sarcopenic obesity based on AWGS2019 criteria had poorer outcomes. The AWGS2019 criteria are comprehensive and more suitable for predicting outcomes in IBD patients, which helps doctors making precise treatment.

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Magnetic resonance imaging assessment of body composition parameters in Crohn's disease

Cited by 14 publications

References 88 publications

Body Composition Predictors of Complicated Crohn’s Disease

Body Composition Predictors of Complicated Crohn’s Disease

Magnetic resonance imaging-based body composition is associated with nutritional and inflammatory status: a longitudinal study in patients with Crohn's disease

Sarcopenia is associated with poor clinical outcomes in patients with inflammatory bowel disease: a prospective cohort study

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