Sarcopenia is a Predictor for Adverse Clinical Outcome in Pediatric Inflammatory Bowel Disease

Atlan, Lilian; Cohen, Shlomi; Shiran, Shelly I.; Sira, Liat Ben; Pratt, Li-tal; Yerushalmy‐Feler, Anat

doi:10.1097/mpg.0000000000003091

Cited by 22 publications

(29 citation statements)

References 44 publications

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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: 80%

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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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Section: Discussionmentioning

confidence: 80%

“…This study had several advantages. 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).…”

Section: Discussionmentioning

confidence: 99%

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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“…There have been numerous reports that sarcopenia is a poor prognostic factor in patients with IBD undergoing surgery [ 19 , 26 , 27 , 30 , 31 , 54 , 81 , 82 , 83 , 84 , 85 , 86 ]. There are also reports that sarcopenia correlates with the severity of IBD [ 31 , 80 ]. There are reports that sarcopenia is helpful in determining treatment decisions for patients with IBD [ 23 ], that skeletal muscle adiposity is associated with prolonged hospitalization and rehospitalization in patients with IBD [ 83 ], and that sarcopenia is associated with osteoporosis in patients with IBD [ 87 ].…”

Section: Prognostic Impact Of Sarcopenia In Patients With Ibdmentioning

confidence: 99%

“…Table 2 shows reports on the relationship between sarcopenia and prognoses in patients with IBD [19,23,26,27,[30][31][32]54,[80][81][82][83][84][85][86][87]. There have been numerous reports that sarcopenia is a poor prognostic factor in patients with IBD undergoing surgery [19,26,27,30,31,54,[81][82][83][84][85][86].…”

Section: Prognostic Impact Of Sarcopenia In Patients With Ibdmentioning

confidence: 99%

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

Nishikawa

Nakamura

Miyazaki

et al. 2021

JCM

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Malnutrition is a major contributor to muscle loss and muscle dysfunction, known as sarcopenia. Malnutrition is common in patients with inflammatory bowel disease (IBD). IBD includes ulcerative colitis (UC) and Crohn’s disease (CD). The number of patients with IBD has recently been increasing. More severe malnutrition is often seen in CD compared to UC, probably due to CD affecting the main site of nutrient absorption, extensive mucosal lesions, fistulas, short bowel syndrome after resection, or obstruction of the gastrointestinal tract. A recent meta-analysis showed the high prevalence of sarcopenia in patients with IBD, and thus sarcopenia is a very important problem for IBD. Although IBD is more common in younger patients, sarcopenia can develop through a variety of mechanisms, including malnutrition, chronic inflammation, increased inflammatory status in adipose tissue, vitamin deficiency, and imbalance of the muscle–gut axis. In addition, sarcopenia has a negative impact on postoperative complications and hospital stay in patients with IBD. Appropriate intervention for sarcopenia may be important, in addition to clinical remission and endoscopic mucosal healing in patients with IBD. Much more attention will thus be paid to sarcopenia in patients with IBD. In this review, we outline IBD and sarcopenia, based on the current evidence.

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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 is a Predictor for Adverse Clinical Outcome in Pediatric Inflammatory Bowel Disease

Abstract: Supplemental Digital Content is available in the text

Cited by 22 publications

References 44 publications

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

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

Inflammatory Bowel Disease and Sarcopenia: Its Mechanism and Clinical Importance

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

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