Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Lee, Ji Young; Kim, Kyung Won; Ko, Yousun; Oh, Chi Hyuk; Kim, Bo Hyun; Park, Seong Jin; You, Myung‐Won

doi:10.3390/diagnostics12112804

Cited by 6 publications

(4 citation statements)

References 44 publications

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“…The results of this study are consistent with the findings of Labarthe et al ( 37 ), who analyzed the correlation between body composition and disease activity level in CD patients using MRI images, although the disease activity level score (Harvey-Bradshaw) used by this team was defined according to the patients’ clinical symptoms. Similarly, the results of a recent study of 71 CD patients with activity follow-up found a negative correlation between SAI and SMI and the disease activity level ( 38 ), which is similar to our findings. In addition, we found more significant differences in body composition-related parameters when the activity levels differed more (remission vs. moderate-to-severe activity).…”

Section: Discussionsupporting

confidence: 93%

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: Discussionsupporting

confidence: 93%

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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“…Sarcopenia remained to be an independent predictor of second‐line therapy failure (OR: 3.401, 95% CI: 1.104–10.479, P = 0.033). In patients who underwent colectomy, the rate of post‐op complications was significantly higher in those with sarcopenia compared with those without sarcopenia (58.6% vs. 33.3% respectively, P = 0.037); sarcopenia alone was an independent risk factor for post‐op complications (OR: 4.157, 95% CI: 1.364–12.667, P = 0.012) in ASUC patients who underwent colectomy 109 . Another larger retrospective study of 254 patients with ASUC similarly assessed muscle mass on CT.…”

Section: Impact On Managementmentioning

confidence: 95%

“…In patients who underwent colectomy, the rate of post-op complications was significantly higher in those with sarcopenia compared with those without sarcopenia (58.6% vs. 33.3% respectively, P = 0.037); sarcopenia alone was an independent risk factor for post-op complications (OR: 4.157, 95% CI: 1.364-12.667, P = 0.012) in ASUC patients who underwent colectomy. 109 Another larger retrospective study of 254 patients with ASUC similarly assessed muscle mass on CT. It showed that patients with myopenia had a significantly higher need for rescue therapy (40.9% vs. 23.6%, P = 0.003) and a need for surgery (22.0% vs. 7.1%, P = 0.001).…”

Section: Impact On Managementmentioning

confidence: 99%

Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence

Neelam,

Sharma,

Sharma

2024

JGH Open

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Sarcopenia is a condition marked by progressive loss of skeletal muscle mass and function while frailty is a multidimensional concept characterized by diminished physiological reserve and increased vulnerability to stressors. Both of these were previously considered as related to aging and shown to impact the quality of life and carry prognostic significance. Emerging data show that both sarcopenia and frailty carry similar relevance in chronic illness. Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and malnourishment, both of which contribute to the development of sarcopenia by increasing protein breakdown and reducing protein synthesis. The coexistence of frailty further compounds the clinical complexity of IBD patients. Published evidence suggests a bidirectional association with IBD contributing to muscle wasting, while the resultant sarcopenia and frailty could further exacerbate the disease course. Sarcopenia and frailty are independently associated with adverse outcomes, including hospitalizations, increased surgical interventions, and surgical complications. As therapeutic strategies for IBD evolve, understanding the nuanced relationship between inflammatory bowel disease, sarcopenia, and frailty is crucial for devising holistic management. Comprehensive care should encompass not only disease‐modifying therapies but also interventions targeting frailty and sarcopenia, as they have been shown to have a significant impact not only on the disease course but also on the quality of life. Future research could focus on further elucidating underlying mechanisms, simple screening strategies, and developing targeted interventions to improve the overall quality of life for individuals grappling with the complex interplay of IBD, sarcopenia, and frailty.

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“…Recent studies have demonstrated the accurate measurement and quanti cation of adipose tissue distribution, particularly the "visceral fat area" (VFA), and muscle mass to assess the grade of myopenia using computed tomography (CT) or magnetic resonance imaging (MRI), and the strong correlation with the visceral fat mass [13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Role of visceral fat on postoperative complications and relapse in patients with Crohn's disease after ileocecal resection: is it overrated?

Schineis,

Pozios,

Boubaris

et al. 2023

Preprint

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Introduction: The role of visceral fat in disease development, particularly in Crohn´s disease (CD), is significant, yet its preoperative prognostic value for postoperative complications and CD relapse remains unknown. This study aims to assess the predictive potential of preoperatively measured visceral and subcutaneous fat in postoperative complications and CD recurrence after ileocecal resection (ICR) using magnetic resonance imaging (MRI). Primary endpoint of the study was postoperative anastomotic leakage of the ileocolonic anastomosis, with secondary endpoints evaluating postoperative complications according to the Clavien Dindo classification and CD recurrence at the anastomosis. Methods: We conducted a retrospective analysis of 347 CD patients who underwent ICR at our tertiary referral center between 2010 and 2020. From this cohort, 223 patients with available high-quality preoperative MRI scans were included in the study. We recorded patient demographics, postoperative outcomes, and rates of CD recurrence at the anastomosis. To assess adipose tissue distribution, we measured the total fat area (TFA), visceral fat area (VFA), subcutaneous fat area (SFA), and abdominal circumference (AC) at the lumbar 3 (L3) level using an established image-analysis method on MRI cross-sectional images. Additionally, we calculated ratios of the aforementioned values. Results: None of the radiological variables showed an association with anastomotic leakage (TFA p=0.932, VFA p=0.982, SFA p=0.951, SFA/TFA p=0.422, VFA/TFA p=0.422), postoperative complications’ rate or CD recurrence (TFA p=0.264, VFA p=0.916, SFA p=0.103, SFA/TFA p=0.059, VFA/TFA p=0.059). Conclusions: None of the radiological visceral obesity variables were associated with postoperative outcomes or clinical recurrence in CD patients undergoing ICR. Measurement of visceral fat may be a good parameter to evaluate the severity of CD activity but is rather unspecific considering the prediction of possible postoperative complications and CD relapse.

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Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Cited by 6 publications

References 44 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

Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence

Role of visceral fat on postoperative complications and relapse in patients with Crohn's disease after ileocecal resection: is it overrated?

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