Schneider Stéphane M, Al-Jaouni Rima, Filippi Jerôme, Wiroth Jean-Baptiste, Zeanandin Gilbert, Arab Kamel, Hébuterne Xavier
Centre Hospitalier Universitaire de Nice, Pôle Digestif, Université de Nice Sophia-Antipolis, Faculté de Médecine, Nice, France.
Inflamm Bowel Dis. 2008 Nov;14(11):1562-8. doi: 10.1002/ibd.20504.
Patients with Crohn's disease (CD) are prone to osteoporosis. A loss of muscle mass, called sarcopenia, is responsible for an increased risk of disability. Many factors associated with osteopenia also decrease muscle mass. The aim of the present study was to measure the prevalence of sarcopenia in CD patients in remission and uncover its relationship with osteopenia.
In all, 82 CD patients (43 female/39 male; 36 +/- 14 years; body mass index [BMI] 21.1 +/- 3.4) and 50 healthy volunteers (30F/20M; 39 +/- 13 years; BMI 22.2 +/- 2.5) were studied. Body composition was assessed using dual-energy x-ray absorptiometry. Sarcopenia was defined as an appendicular skeletal muscle index (ASMI) below 5.45 kg/m(2) for women and 7.26 for men. Osteopenia was defined as a T-score for bone mineral density (BMD) (g/cm(2)) below -1.0.
In all, 60% of CD patients were found to be sarcopenic and 30% osteopenic, compared to 16% and 4% of controls, respectively (P < 0.01). ASMI was significantly lower in patients than in controls (6.0 +/- 1.1 versus 6.5 +/- 1.2; P < 0.05). Sarcopenic patients had significantly (P < 0.01) lower BMI (20.0 +/- 3.5 versus 22.7 +/- 2.8 kg/m(2)), lean mass (41.5 +/- 9.1 versus 48.1 +/- 9.1 kg), and BMD (1.09 +/- 0.12 versus 1.15 +/- 0.08 g/cm(2)) than nonsarcopenic patients; 91% of sarcopenic patients were also osteopenic. ASMI correlated with BMD (r = 0.46; P < 0.01) and BMI (r = 0.38; P < 0.01).
The prevalence of sarcopenia is high in young CD patients and strongly related to osteopenia. These 2 phenomena may share similar mechanisms. Simultaneous screening for sarcopenia and osteopenia may be useful in CD patients.
克罗恩病（CD）患者易患骨质疏松症。肌肉量减少，即肌肉减少症，会导致残疾风险增加。许多与骨质减少相关的因素也会降低肌肉量。本研究的目的是测量缓解期CD患者中肌肉减少症的患病率，并揭示其与骨质减少的关系。
共研究了82例CD患者（43例女性/39例男性；36±14岁；体重指数[BMI]21.1±3.4）和50名健康志愿者（30名女性/20名男性；39±13岁；BMI 22.2±2.5）。使用双能X线吸收法评估身体成分。肌肉减少症定义为女性四肢骨骼肌指数（ASMI）低于5.45kg/m²，男性低于7.26kg/m²。骨质减少定义为骨密度（BMD）（g/cm²）的T值低于-1.0。
总体而言，发现60%的CD患者有肌肉减少症，30%有骨质减少症，而对照组分别为16%和4%（P<0.01）。患者的ASMI显著低于对照组（6.0±1.1对6.5±1.2；P<0.05）。与非肌肉减少症患者相比，肌肉减少症患者的BMI（20.0±3.5对22.7±2.8kg/m²）、瘦体重（41.5±9.1对48.1±9.1kg）和BMD（1.09±0.12对1.15±0.08g/cm²）显著更低（P<0.01）；91%的肌肉减少症患者也有骨质减少。ASMI与BMD（r=0.46；P<0.01）和BMI（r=0.38；P<0.01）相关。
年轻CD患者中肌肉减少症的患病率很高，且与骨质减少密切相关。这两种现象可能有相似的机制。对CD患者同时筛查肌肉减少症和骨质减少症可能有用。
