Lee Chan Hyung, Yoon Hyuk, Oh Dong Jun, Lee Jae Min, Choi Yoon Jin, Shin Cheol Min, Park Young Soo, Kim Nayoung, Lee Dong Ho, Kim Joo Sung
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Intest Res. 2020 Jan;18(1):79-84. doi: 10.5217/ir.2019.00107. Epub 2020 Jan 30.
BACKGROUND/AIMS: Crohn's disease is associated with altered body composition, such as low muscle mass, which can affect clinical outcomes. However, there are few studies regarding the effect of sarcopenia on prognosis of Crohn's disease. In this study, we evaluated the body composition at the initial diagnosis of Crohn's disease and analyzed the clinical meaning of sarcopenia.
We conducted a retrospective review of medical records of patients who were diagnosed as Crohn's disease and underwent computed tomography within 3 months after diagnosis. Sarcopenia was defined as an L3 skeletal muscle index (SMI) of < 49 cm2/m2 for men and < 31 cm2/m2 for women. Outcomes such as need for hospitalization, surgery, use of steroids, immunomodulators and biologics were analyzed.
A total of 79 patients (male, 73.4%; mean age, 29.9 years) were included and 40 patients (51%) were diagnosed as sarcopenia. C-reactive protein (CRP) level was correlated with sarcopenia (P= 0.044). Erythrocyte sedimentation rate (ESR) showed a tendency to decrease inversely with SMI (r = -0.320, P= 0.008) and hemoglobin and albumin tended to increase in proportion to SMI (hemoglobin: r = 0.271, P= 0.016 and albumin: r = 0.350, P= 0.002). However, there was no statistically significance in time-to-first-event analysis in aspects of sarcopenia.
Approximately 50% of patients with newly diagnosed as Crohn's disease had sarcopenia. CRP levels were higher in the sarcopenia group and SMI correlated with ESR, hemoglobin, and albumin. However, none of prognostic values were demonstrated.
背景/目的:克罗恩病与身体成分改变有关,如肌肉量减少,这可能影响临床结局。然而,关于肌肉减少症对克罗恩病预后影响的研究较少。在本研究中,我们评估了克罗恩病初诊时的身体成分,并分析了肌肉减少症的临床意义。
我们对被诊断为克罗恩病且在诊断后3个月内接受计算机断层扫描的患者的病历进行了回顾性分析。肌肉减少症的定义为男性L3骨骼肌指数(SMI)<49 cm²/m²,女性<31 cm²/m²。分析了住院需求、手术、类固醇、免疫调节剂和生物制剂使用等结局。
共纳入79例患者(男性占73.4%;平均年龄29.9岁),40例患者(51%)被诊断为肌肉减少症。C反应蛋白(CRP)水平与肌肉减少症相关(P = 0.044)。红细胞沉降率(ESR)显示出与SMI呈负相关的趋势(r = -0.320,P = 0.008),血红蛋白和白蛋白则倾向于与SMI成比例增加(血红蛋白:r = 0.271,P = 0.016;白蛋白:r = 0.350,P = 0.00)。然而,在肌肉减少症方面的首次事件时间分析中没有统计学意义。
新诊断为克罗恩病的患者中约50%有肌肉减少症。肌肉减少症组的CRP水平较高,SMI与ESR、血红蛋白和白蛋白相关。然而,未显示出任何预后价值。