Sarcopenia and Vitamin D Deficiency in Patients with Crohn’s Disease: Pathological Conditions That Should Be Linked Together

Palmese, Francesco; Toro, Rossella Del; Marzio, Giulia Di; Cataleta, Pierluigi; Sama, Maria Giulia; Domenicali, Marco

doi:10.3390/nu13041378

Cited by 11 publications

(9 citation statements)

References 82 publications

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“…Crohn’s disease (CD) is an inflammatory bowel disease that can involve any part of the gastrointestinal tract and is characterized by alternating relapses and remissions, which can result in a variety of complications, such as intestinal strictures, perforations, and fistulas, severely reducing the quality of life of patients ( 1 ). During the course of chronic inflammatory disease in CD patients, 65–75% of patients may experience malnutrition due to dietary restrictions and impaired digestion and absorption ( 2 ), while the chronic malnutrition status may lead to an imbalance of the intestinal flora and further exacerbate the inflammatory response of the intestine ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Tang,

Xie,

et al. 2023

Front. Nutr.

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BackgroundThe disease activity status and behavior of Crohn’s disease (CD) can reflect the severity of the disease, and changes in body composition are common in CD patients.AimsThe aim of this study was to investigate the relationship between body composition parameters and disease severity in CD patients treated with infliximab (IFX).MethodsPatients with CD assessed with the simple endoscopic score (SES-CD) and were treated with IFX were retrospectively collected, and body composition parameters at the level of the 3rd lumbar vertebrae were calculated from computed tomography (CT) scans of the patients. The correlation of patients’ body composition parameters with disease activity status and disease behavior was analyzed, and the diagnostic value of the relevant parameters was assessed using receiver operating characteristic (ROC) curves.ResultsA total of 106 patients were included in this study. There were significant differences in the subcutaneous adiposity index (SAI) (p = 0.010), the visceral adiposity index (VAI) (p < 0.001), the skeletal muscle mass index (SMI) (p < 0.001), and decreased skeletal muscle mass (p < 0.001) among patients with different activity status. After Spearman and multivariate regression analysis, SAI (p = 0.006 and p = 0.001), VAI (p < 0.001 and p < 0.001), and SMI (p < 0.001and p = 0.007) were identified as independent correlates of disease activity status (both disease activity and moderate-to-severe activity), with disease activity status independently positively correlated with SAI and SMI and independently negatively correlated with VAI. In determining the disease activity and moderate-to-severe activity status, SMI performed best relative to SAI and VAI, with areas under the ROC curve of 0.865 and 0.801, respectively. SAI (p = 0.015), SMI (p = 0.011) and decreased skeletal muscle mass (p = 0.027) were significantly different between different disease behavior groups (inflammatory disease behavior group, complex disease behavior group) but were not independent correlates (p > 0.05).ConclusionBody composition parameters of CD patients treated with IFX correlate with the endoscopic disease severity, and SMI can be used as a reliable indicator of disease activity status.

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Section: Introductionmentioning

confidence: 99%

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Tang,

Xie,

et al. 2023

Front. Nutr.

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“…Vitamin D plays the important role in regulating body metabolism and maintaining normal physiological functions in the human body, vitamin D deficiency or vitamin D insufficiency could cause a series of diseases including osteomalacia [10], rheumatoid arthritis [11], diabetes mellitus [12], Crohn's disease [13] and immune diseases [14]; seasonal emotional disorders are also associated with vitamin D deficiency [15], different age stages including pregnancy and early childhood growth also require vitamin D supplementation [16,17]. The evidences demonstrated that people with limited outdoor activities, vegetarians, patients with celiac disease, people taking some kinds of special medications, and other risk factors including high latitude, lack of sunlight, age, obesity also could result in the vitamin D deficiency those results demonstrated that the vitamin D deficiency may affect the situation of the adult diabetes mellitus patients, and gender, age, and seasons could be the main risk factors.…”

Section: Discussionmentioning

confidence: 99%

The epidemiological investigation of vitamin D deficiency in northern Henan province

Deng,

Lin,

Yang

2023

Preprint

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Aim/purposeTo analyze the epidemiology of vitamin D deficiency in northern Henan province, to lay the foundation for prevention and treatment of vitamin D deficiency and the vitamin D related diseases.MethodsWe collected the basic information including gender, age, and vitamin D concentration of 22184 people who detected the 25 hydroxyvitamin D concentration in the Third Affiliated Hospital of Xinxiang Medical University from June 2020 to May 2023, analyzed the vitamin D deficiency distribution in male children population, female children population, male adult population and female adult population; and the differences of 25 hydroxyvitamin D concentration of diabetes mellitus patients in the total investigation population in northern Henan province were also analyzed and compared according to gender, age and different seasons.ResultsA total of 22184 data were collected from June 2020 to May 2023 in the Third Affiliated Hospital of Xinxiang Medical University; the age range of investigation objects was from 1 month to 93 years old; there were 8176 male people and 14008 female people, accounting for 36.86% and 63.14% in the total investigation population, respectively; there were 1318 diabetes mellitus patients, accounting for 5.94% in the total investigation population; there were 796 males and 522 females, accounting for 60.39% and 39.61% in the total 1318 diabetes mellitus patients, respectively; the investigation results demonstrated that the number of people with vitamin deficiency was 278, the number of people with vitamin insufficiency was 1418, and the number of people with normal vitamin concentration was 20488, accounting for 1.25%, 6.39% and 92.35% in the total investigation population, respectively; in the adult female population, the number of people with vitamin deficiency and with vitamin insufficiency were highest compared the male children population, female population and male adult population; the statistical results demonstrated that there were the significantly statistical differences among vitamin D concentration<25nmol/mL population, vitamin D concentration at 25-49 nmol/mL population, and vitamin D concentration at 50∼80 nmol/mL in female adult population at the different age (P=0.0039); and there were no statistical differences in male children population, male adult population and female children population at different ages and at different vitamin D concentrations (P>0.05); the results demonstrated that there were the significantly differences among vitamin D concentration<25nmol/mL population, vitamin D concentration at 25-49 nmol/mL population, and vitamin D concentration at 50∼80 nmol/mL in adult diabetes mellitus population at gender, age and different seasons.92.35% people in northern Henan province had the normal vitamin concentration, there were 7.65% people with vitamin insufficiency or vitamin deficiency in northern Henan province; the number of people with vitamin deficiency and with vitamin insufficiency were highest in the adult female population, and there were the significantly statistical differences in female adult population at the different age at different vitamin concentration population and in diabetes mellitus adult population at gender, age and different seasons.ConclusionThe incidence rate of vitamin insufficiency or vitamin deficiency in northern Henan province was 7.65%, and the epidemiology of vitamin D deficiency in northern Henan province had the specific characteristics. Those evidences may provide useful information for prevention and treatment of vitamin D deficiency and vitamin D related diseases.

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“…Sarcopenia due to malnutrition has emerged as an important problem for CD patients. 16 17 18 There have been efforts made to quantify the body composition of CD patients using the psoas muscle area on routine MRI. 19 In our study, psoas muscle thickness was significantly lower in CD patients on initial abdominal CT (19.2 mm vs. 22 mm, p =0.040).…”

Section: Discussionmentioning

confidence: 99%

Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn’s Disease in Children

et al. 2022

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Purpose To identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn’s disease (CD) in children. Materials and Methods In this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 and had abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diagnosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were included as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CD using logistic regression and the area under the curve (AUC). Results In total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (median 13 years old vs. 11 years old, p =0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesenteric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×10 3 /µL) levels were significant factors for CD. On multivariate analysis, multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778–2605.925] and lower albumin levels (OR 0.9, 95% CI 0.891–0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with a sensitivity of 96% and specificity of 100% for differentiating CD. Conclusion Multisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectious enterocolitis in children prior to a definite diagnosis of CD.

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Sarcopenia and Vitamin D Deficiency in Patients with Crohn’s Disease: Pathological Conditions That Should Be Linked Together

Cited by 11 publications

References 82 publications

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

Body composition parameters correlate with the endoscopic severity in Crohn’s disease patients treated with infliximab

The epidemiological investigation of vitamin D deficiency in northern Henan province

Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn’s Disease in Children

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